Healthcare Provider Details

I. General information

NPI: 1144983925
Provider Name (Legal Business Name): NINA LIZ GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 AV JESUS T. PINERO KM 55.4 INT
CAYEY PR
00736
US

IV. Provider business mailing address

URB. VILLA CARMEN CALLE MAYAGUEZ B36
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-263-5166
  • Fax:
Mailing address:
  • Phone: 787-469-4883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8481
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: