MEDICARE: MICHAEL MANUEL GUZMAN MS OTL

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	225X00000X	Occupational Therapist	1075	PR

General Provider Information

NPI Number	:	1306022512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MANUEL GUZMAN MS OTL

Provider Business Mailing Address
First Line	:	1710 CALLE TER
Second Line	:	URB. RIO PIEDRAS HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3253
Country	:	US
Telephone Number	:	939-639-5560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 CALLE TER
Second Line	:	URB. RIO PIEDRAS HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3253
Country	:	US
Telephone Number	:	939-639-5560
Fax Number	:

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

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	01/17/2008

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