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NPI Code Detail

MEDICARE: MR. DAVID GUZMAN-NIEVES PH.T.

MEDICARE: MR. DAVID GUZMAN-NIEVES PH.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183700000XPharmacy Technician3078PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13078OTHERPRPHARMACY TECHNICIAN

General Provider Information

NPI Number : 1366429078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID GUZMAN-NIEVES PH.T.
Provider Business Mailing Address
First Line : RESIDENCIAL LOPEZ NUSSA
Second Line : BLQ 1 APT 9
City : PONCE
State : PR
Zip : 00717
Country : US
Telephone Number : 787-642-7624
Fax Number : 787-841-5551
Provider Business Practice Location Address
First Line : 553 CALLE RAMOS ANTONINI
Second Line : EL TUQUE
City : PONCE
State : PR
Zip : 00728-4806
Country : US
Telephone Number : 787-844-2805
Fax Number : 787-841-5551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 07/08/2007

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