Healthcare Provider Details

I. General information

NPI: 1134242233
Provider Name (Legal Business Name): MISS KAREN DALIA GUZMAN-ROSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 5090 BO. PIEDRA GORDA
CAMUY PR
00627-9612
US

IV. Provider business mailing address

HC 01 BOX 5090 BO. PIEDRA GORDA
CAMUY PR
00627
US

V. Phone/Fax

Practice location:
  • Phone: 787-898-6599
  • Fax: 787-262-1210
Mailing address:
  • Phone: 787-898-6599
  • Fax: 787-262-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number004165
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: