Provider Demographics
NPI:1104217355
Name:GSPROFESSIONALS, LLC
Entity type:Organization
Organization Name:GSPROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LILLAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-426-2554
Mailing Address - Street 1:1353 AVE LUIS VIGOREAUX
Mailing Address - Street 2:PMB 314
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2715
Mailing Address - Country:US
Mailing Address - Phone:787-426-2554
Mailing Address - Fax:
Practice Address - Street 1:B5 CALLE TABONUCO
Practice Address - Street 2:SUITE 211
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3004
Practice Address - Country:US
Practice Address - Phone:787-426-2554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18377207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty