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General NPI Number Information
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NPI Number | 1639231418
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Entity Type | Individual
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Provider Name | JUAN ANTONIO GUILLEN MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | AVE BARBOSA #65 ESQ JOSE DE DIEGO ARCCIBO MEDICAL PLAZA #103
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City | ARCCIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 787-880-2662
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Fax | 787-880-2662
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Provider Business Mailing Address
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Address Line | PO BOX 140177
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City | ARCCIBO
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State | PR
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Zip | 00614
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Country | US
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Telephone | 787-880-2662
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Fax | 787-880-2662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4586
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License Number State | PR
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