Provider Demographics
NPI:1194713982
Name:SANZ LEBRON, GERARDO
Entity type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:SANZ LEBRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAS TORRES SUR
Mailing Address - Street 2:3 CALLE ISLETA STE 2E
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5921
Mailing Address - Country:US
Mailing Address - Phone:787-949-1234
Mailing Address - Fax:
Practice Address - Street 1:EDIF LAS TORRES SUR
Practice Address - Street 2:SUTE 2-B
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5920
Practice Address - Country:US
Practice Address - Phone:787-785-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1367103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical