Provider Demographics
NPI:1184204232
Name:SEDA POMBROL, GABRIEL EUGENIO
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:EUGENIO
Last Name:SEDA POMBROL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0216
Mailing Address - Country:US
Mailing Address - Phone:787-538-8884
Mailing Address - Fax:
Practice Address - Street 1:TORRE MEDICA SAN VICENTE DE PAUL
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24126208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice