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General NPI Number Information
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NPI Number | 1770582298
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Entity Type | Individual
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Provider Name | JOSE A RIVERA GUZMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | AVE. ASHFORD, ESQ. WASHINGTON #29 SUITE 505 ASHFORD MEDICAL CENTER
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City | SAN JUAN
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State | PR
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Zip | 00907-2300
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Country | US
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Telephone | 787-721-2324
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Fax | 787-721-2204
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Provider Business Mailing Address
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Address Line | PO BOX 11009
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City | SAN JUAN
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State | PR
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Zip | 00910-2109
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Country | US
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Telephone | 787-402-1764
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Fax | 787-721-2204
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 13554
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License Number State | PR
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