Healthcare Provider Details

I. General information

NPI: 1740261577
Provider Name (Legal Business Name): NORMA R GUERRA TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/28/2009
Certification Date:
Deactivation Date: 07/17/2007
Reactivation Date: 07/22/2009

III. Provider practice location address

CALLE ANGEL MARTINEZ ESQ. SAN ISIDRO 25B
SABANA GRANDE PR
00637-1179
US

IV. Provider business mailing address

PO BOX 1179
SABANA GRANDE PR
00637
US

V. Phone/Fax

Practice location:
  • Phone: 787-804-0399
  • Fax: 787-873-5555
Mailing address:
  • Phone: 787-804-0399
  • Fax: 787-873-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number13448
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: