Provider Demographics
NPI:1881607026
Name:GOMEZ SALDANA, WILFRED (MD)
Entity type:Individual
Prefix:DR
First Name:WILFRED
Middle Name:
Last Name:GOMEZ SALDANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15017 VEREDA VERDE
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-9622
Mailing Address - Country:US
Mailing Address - Phone:787-256-4099
Mailing Address - Fax:787-256-4099
Practice Address - Street 1:ROAD. 185 KM 5.0
Practice Address - Street 2:BO CAMPO RICO
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-256-4099
Practice Address - Fax:787-256-4099
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13723282NC0060X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022020Medicare ID - Type UnspecifiedFAMILY MEDICINE