Healthcare Provider Details

I. General information

NPI: 1740240043
Provider Name (Legal Business Name): PAUL ANTHONY GUZMAN VALIDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB SANFELIZ CALLE 1#1 SUITE 2B
COROZAL PR
00783
US

IV. Provider business mailing address

PMB 435 CARR 693 SUITE 1
DORADO PR
00646-4817
US

V. Phone/Fax

Practice location:
  • Phone: 787-483-0956
  • Fax:
Mailing address:
  • Phone: 787-483-0956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number33313
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number12513
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: