MEDICARE: GUAYNABO EMERGENCY MEDICINE, LLC

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	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1801500392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUAYNABO EMERGENCY MEDICINE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1239
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00970-1239
Country	:	US
Telephone Number	:	787-364-9797
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 AVE LAS CUMBRES
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00969-4818
Country	:	US
Telephone Number	:	787-364-9797
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEONARDO VALENTIN
Credential	:	MD
Telephone Number	:	787-364-9797

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	01/09/2023

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