Provider Demographics
NPI:1699575001
Name:VIRUET PANTOJA, GABRIELA PAOLA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:PAOLA
Last Name:VIRUET PANTOJA
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 1:200 CARR 149 # URB
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-9525
Mailing Address - Country:US
Mailing Address - Phone:787-503-9669
Mailing Address - Fax:
Practice Address - Street 1:200 CARR 149 # URB
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-9525
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty