Healthcare Provider Details

I. General information

NPI: 1457821431
Provider Name (Legal Business Name): JONATHAN GUZMAN CRUZ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTEHIEDRA, LOS ROMEROS AVE. RIO PIEDRAS
SAN JUAN PR
00923
US

IV. Provider business mailing address

CALLE 13A DD5 VILLA DEL REY 4
CAGUAS PR
00727
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-1462
  • Fax:
Mailing address:
  • Phone: 787-509-3880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number006591
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: