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General NPI Number Information
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NPI Number | 1932178910
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Entity Type | Individual
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Provider Name | WANDALIZ RODRIGUEZ GUZMAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | CARR. 459, KM 3.9 BO. CAMASEYES
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City | AGUADILLA
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State | PR
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Zip | 00603-6083
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Country | US
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Telephone | 787-243-6215
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Fax | 787-243-6215
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Provider Business Mailing Address
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Address Line | PO BOX 5164
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City | AGUADILLA
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State | PUERTO RICO
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Zip | 00605
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Country | UM
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Telephone | 787-243-6215
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Fax | 787-243-6215
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 13789
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 13789
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License Number State | PR
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