Provider Demographics
NPI:1740474865
Name:DE LA TORRE BISOT, GABRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:DE LA TORRE BISOT
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 1:909 AVE TITO CASTRO
Mailing Address - Street 2:502 TORRE MEDICA SAN LUCAS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-4728
Mailing Address - Country:US
Mailing Address - Phone:787-651-3888
Mailing Address - Fax:787-651-7325
Practice Address - Street 1:909 AVE TITO CASTRO
Practice Address - Street 2:502 TORRE MEDICA SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4728
Practice Address - Country:US
Practice Address - Phone:787-565-4351
Practice Address - Fax:787-651-7325
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17371208D00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice