Healthcare Provider Details

I. General information

NPI: 1649766304
Provider Name (Legal Business Name): MADELINE GUERRERO GONZALEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 16137
AGUADILLA PR
00603-9353
US

IV. Provider business mailing address

HC 1 BOX 16137
AGUADILLA PR
00603-9353
US

V. Phone/Fax

Practice location:
  • Phone: 305-537-8377
  • Fax:
Mailing address:
  • Phone: 305-537-8377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22316
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number22316
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: