Healthcare Provider Details

I. General information

NPI: 1043209414
Provider Name (Legal Business Name): DR. FRANCISCO J GUZMAN LUGO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 AVE 21 DE DICIEMBRE OFICINA 4-5
SABANA GRANDE PR
00634
US

IV. Provider business mailing address

PO BOX 197
SABANA GRANDE PR
00637-0197
US

V. Phone/Fax

Practice location:
  • Phone: 787-873-3222
  • Fax: 787-873-3223
Mailing address:
  • Phone: 787-873-3222
  • Fax: 787-873-3222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12898
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: