Provider Demographics
NPI:1285419630
Name:GUARDADO, CAROLYN (RN)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:GUARDADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. CUPEY GARDENS F12 CALLE 9
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:510-408-8019
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO CARIBBEAN TOWERS
Practice Address - Street 2:670 AVE PONCE DE LEON APT 619
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:510-408-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95216882163W00000X
PR89658163W00000X
PR89658G163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse