Healthcare Provider Details

I. General information

NPI: 1043754807
Provider Name (Legal Business Name): GRISELA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2016
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 CALLE GUILLERMO RIEFKKOHL
PATILLAS PR
00723
US

IV. Provider business mailing address

99 CALLE GUILLERMO RIEFKKOHL
PATILLAS PR
00723
US

V. Phone/Fax

Practice location:
  • Phone: 787-839-4320
  • Fax: 787-271-0004
Mailing address:
  • Phone: 787-839-4320
  • Fax: 787-271-0004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number90489
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: