Provider Demographics
NPI:1194304105
Name:PEREZ GUZMAN, YASHIRA MARIE (MD)
Entity type:Individual
Prefix:
First Name:YASHIRA
Middle Name:MARIE
Last Name:PEREZ GUZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-0096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR. # 5 INDUSTRIAL LUCHETTI
Practice Address - Street 2:MARGINAL FINAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7403
Practice Address - Country:US
Practice Address - Phone:939-225-2400
Practice Address - Fax:787-288-1115
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR091-PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant