Healthcare Provider Details

I. General information

NPI: 1598726952
Provider Name (Legal Business Name): ANDRES M MAYMI GUERRA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 HOSTOS AVE SUITE 310 MEDICAL EMPORIUM BUILDING
MAYAGUES PR
00680
US

IV. Provider business mailing address

351 HOSTOS AVE SUITE 310 MEDICAL EMPORIUM BUILDING
MAYAGUES PR
00680
US

V. Phone/Fax

Practice location:
  • Phone: 787-832-0899
  • Fax: 787-833-6434
Mailing address:
  • Phone: 787-832-0899
  • Fax: 787-833-6434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0076
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number76
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: