Healthcare Provider Details

I. General information

NPI: 1023071883
Provider Name (Legal Business Name): DARGEE EMID GUEVAREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDOMINIO SAN VICENTE CONCORDIA #8169 SUITE 405
PONCE PR
00717
US

IV. Provider business mailing address

BRISAS DEL PRADO 2025 GUARAGUAO
SANTA ISABEL PR
00757-2175
US

V. Phone/Fax

Practice location:
  • Phone: 787-284-3724
  • Fax: 787-284-3724
Mailing address:
  • Phone: 787-448-0222
  • Fax: 787-284-3724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number13671
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: