Healthcare Provider Details

I. General information

NPI: 1851577050
Provider Name (Legal Business Name): YELITZA R. GUZMAN MORENO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE PERAL # 29 N SUITE 7
MAYAGUEZ PR
00680-4894
US

IV. Provider business mailing address

URB TERRAZAS DE BOQUERON BOX 41
BOQUERON PR
00622
US

V. Phone/Fax

Practice location:
  • Phone: 787-356-0262
  • Fax:
Mailing address:
  • Phone: 787-356-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1393
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: