Gastrovem, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

GASTROVEM, LLC

Practice address

1607 Ave Ponce de Leon Ste GM04
San Juan, PR 00909-1803

Phone

(787) 910-0909

Fax

(888) 588-0319

NPI assigned

Oct 16, 2013

Last updated

Jul 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Vasco Eguia Moreda, MDNPI 1316184161

Title

President Owner

Phone

(787) 633-5263

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vasco Eguia Moreda, MD

  • Gastroenterology Physician
  • San Juan, PR
  • NPI 1316184161
  Authorized official Same address or phone

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1467880146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 AVE LUIS VIGOREAUX PMB 757",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662715",
            "telephone_number": "787-910-0909",
            "fax_number": "888-588-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 AVE PONCE DE LEON STE GM04",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009091803",
            "telephone_number": "787-910-0909",
            "fax_number": "888-588-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROVEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2021-07-27",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "EGUIA MOREDA",
        "authorized_official_first_name": "VASCO",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "787-633-5263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037939901",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carolina Gaud Rodriguez, MD
• Frank A Gaudier Guerra, M.D.
• Rodulfo A Gauthier, DMD
• Nieves J Gaztambide, M.D.
• GCM Medical Group, PSC

• Gastroenterology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Gastroenterology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.