Healthcare Provider Details

I. General information

NPI: 1962129841
Provider Name (Legal Business Name): MISS EVA MARIA CHAVES GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KM 8.3 AVE 65 INFANTERIA
CAROLINA PR
00984
US

IV. Provider business mailing address

PO BOX 769
QUEBRADILLAS PR
00678-0769
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-0101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24872
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: