Provider Demographics
NPI:1841807815
Name:ESTRADA, GRETCHEN (MD)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB SAGRADO CORAZON
Mailing Address - Street 2:1755 CALLE SANTA PRAXEDES
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-639-3721
Mailing Address - Fax:
Practice Address - Street 1:MEMORIAL HEALTHCARE SYSTEM
Practice Address - Street 2:7800 SHERIDAN ST
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-2536
Practice Address - Country:US
Practice Address - Phone:195-496-2965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22665OtherMEDICAL LICENSE NUMBER