Healthcare Provider Details

I. General information

NPI: 1730196247
Provider Name (Legal Business Name): WILBERTO GUZMAN ALVARADO M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 CALLE PARANA EL CEREZAL
RIO PIEDRAS PR
00926-3148
US

IV. Provider business mailing address

1716 CALLE PARANA EL CEREZAL
RIO PIEDRAS PR
00926-3148
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-8548
  • Fax: 787-282-0483
Mailing address:
  • Phone: 787-766-8548
  • Fax: 787-282-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number11015
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: