Provider Demographics
NPI:1598510414
Name:AGUAYO GOMEZ, PIA CHANTAL
Entity type:Individual
Prefix:MISS
First Name:PIA
Middle Name:CHANTAL
Last Name:AGUAYO GOMEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 AVE LA SIERRA BOX 43
Mailing Address - Street 2:CALLE 5 D4
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-461-5656
Mailing Address - Fax:
Practice Address - Street 1:300 AVE LA SIERRA BOX 43
Practice Address - Street 2:CALLE 5 D4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-461-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program