| Doctor Name: | DR. ROEL ELFRIETH GARDESLEN |
| NPI Number: | 1902137698 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MEDICINE |
| License Number: | 17716 |
| Business Practice Address: | #5 Urb.las Flores J7 Juana Diaz, PR - 00795 |
| Business Phone Number: | 7879010815 |
| Business Fax Number: | |
| Mailing Address: | #5 Urb.las Flores J7, JUANA DIAZ |
| State: | PR |
| Postal Code: | 00795 |
| Phone Number: | 7879010815 |
| Fax Number: | |
| NPI Enumeration Date: | 01/20/2010 |
| NPI Last Update Date: | 01/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17716 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |