Healthcare Provider Details

I. General information

NPI: 1962424267
Provider Name (Legal Business Name): ANGELICA GUZMAN M. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIF LA PALMA SUITE 2A
MAYAGUEZ PR
00680-4861
US

IV. Provider business mailing address

PO BOX 1496
MAYAGUEZ PR
00681-1496
US

V. Phone/Fax

Practice location:
  • Phone: 787-833-0348
  • Fax: 787-805-0710
Mailing address:
  • Phone: 787-833-0348
  • Fax: 787-805-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3389
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: