Healthcare Provider Details

I. General information

NPI: 1659235588
Provider Name (Legal Business Name): MIGUEL ANGEL GUZMAN FUENTES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB BUCARE CALLE ONIX 11
GUAYNABO PR
00969
US

IV. Provider business mailing address

URB BUCARE CALLE ONIX 11
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-321-2477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: