Healthcare Provider Details

I. General information

NPI: 1902352883
Provider Name (Legal Business Name): NEW HORIZONS HEMATOLOGY & ONCOLOGY GROUP PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 CALLE SERGIO CUEVAS BUSTAMANTE HOSPITAL DEL MAESTRO SUITE 2002
SAN JUAN PR
00918-2002
US

IV. Provider business mailing address

100 AVE LA SIERRA APT. H-128
SAN JUAN PR
00926-4316
US

V. Phone/Fax

Practice location:
  • Phone: 787-763-7365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number18342
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number18342
License Number StatePR

VIII. Authorized Official

Name: DR. EDGARDO SANTIAGO GUZMAN
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 787-380-9738