Healthcare Provider Details

I. General information

NPI: 1548204407
Provider Name (Legal Business Name): YOILIS GUERRERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A5 LOS ADOQUINES PASEO SULTANITA
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

A5 LOS ADOQUINES PASEO SULTANITA
MAYAGUEZ PR
00680
US

V. Phone/Fax

Practice location:
  • Phone: 787-646-3549
  • Fax: 787-834-6850
Mailing address:
  • Phone: 787-646-3549
  • Fax: 787-834-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number15507
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: