MEDICARE: CARMEN MARGARITA GURREA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0101X	Anatomic Pathology Physician	6194	PR

General Provider Information

NPI Number	:	1013957224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN MARGARITA GURREA M.D.

Provider Business Mailing Address
First Line	:	E12 CALLE MALAGA
Second Line	:	VISTAMAR MARINA,
City	:	CAROLINA
State	:	PR
Zip	:	00983-1507
Country	:	US
Telephone Number	:	787-721-1684
Fax Number	:	787-721-1684

Provider Business Practice Location Address
First Line	:	SAN JUAN HEALTH CENTRE, SUITE 610
Second Line	:	200 DE DIEGO AVE.
City	:	SANTURCE
State	:	PR
Zip	:	00907-2318
Country	:	US
Telephone Number	:	787-723-1674
Fax Number	:	787-721-1684

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/08/2007

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