Healthcare Provider Details

I. General information

NPI: 1013600345
Provider Name (Legal Business Name): DAVID CORTES GUZMAN PSY D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2M1 CALLE 55
CAROLINA PR
00987-7514
US

IV. Provider business mailing address

PO BOX 1459
TRUJILLO ALTO PR
00977-1459
US

V. Phone/Fax

Practice location:
  • Phone: 787-226-0825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1491
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: