MEDICARE: DR. REINALDO ROSARIO GUARDIOLA 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	207N00000X	Dermatology Physician	4262	PR

General Provider Information

NPI Number	:	1043234941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REINALDO ROSARIO GUARDIOLA M.D.

Provider Business Mailing Address
First Line	:	652 AVE MUNOZ RIVERA
Second Line	:	SUITE 3170
City	:	SAN JUAN
State	:	PR
Zip	:	00918-4257
Country	:	US
Telephone Number	:	787-765-2305
Fax Number	:	787-764-1359

Provider Business Practice Location Address
First Line	:	652 AVE MUNOZ RIVERA
Second Line	:	SUITE 3170
City	:	SAN JUAN
State	:	PR
Zip	:	00918-4257
Country	:	US
Telephone Number	:	787-765-2305
Fax Number	:	787-764-1359

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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