Healthcare Provider Details

I. General information

NPI: 1457186579
Provider Name (Legal Business Name): GUAYAMA NATUROPATHIC MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C-1 KM 138.2 CARRETERA ESTATAL # 3 ESQUINA CALLE BERING
GUAYAMA PR
00784
US

IV. Provider business mailing address

URB JARDINES DE LAFAYETTE NH-12
ARROYO PR
00714
US

V. Phone/Fax

Practice location:
  • Phone: 787-628-2657
  • Fax:
Mailing address:
  • Phone: 787-341-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAYSON O FUENTES SOTO
Title or Position: NATUROPATHIC DOCTOR
Credential: ND
Phone: 787-341-9758