Individual provider Active NPI

Gustavo Abdiel Laabes Gonzalez, M.D.

  • General Practice Physician
  • Aguada, PR
National Provider Identifier
1194957845
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17717 Issued in PR
Practice address
Carr 417 KM 2.7
Bo Malpaso
Aguada, PR 00602-9857
Phone
(787) 868-8811
NPI assigned
Aug 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17717 PR Primary

Addresses

Primary practice location

Carr 417 KM 2.7
Bo Malpaso
Aguada, PR 00602-9857

Mailing address

510 Calle Francisco Camacho Apt 1104
Isabela, PR 00662-2442
Phone (787) 585-7580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110620000249 PR Practitioner - General Practice 4789862871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17717PRMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1194957845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CALLE FRANCISCO CAMACHO APT 1104",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006622442",
            "telephone_number": "787-585-7580",
            "fax_number": "787-868-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 417 KM 2.7",
            "address_2": "BO MALPASO",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006029857",
            "telephone_number": "787-868-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAABES GONZALEZ",
        "first_name": "GUSTAVO",
        "middle_name": "ABDIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-13",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguada, PR

Sources for this page

Verify at the official NPI Registry.