Provider Demographics
NPI:1386712388
Name:GUZMAN ORTIZ, CARLOS JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:JAVIER
Last Name:GUZMAN ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1379
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1379
Mailing Address - Country:US
Mailing Address - Phone:787-735-6995
Mailing Address - Fax:787-735-0220
Practice Address - Street 1:CARR 726 CALLE JOSE C VAZQUEZ EDIFICIO PROFESIONAL
Practice Address - Street 2:OFICINA 203 BARRIO CAONILLAS
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-6995
Practice Address - Fax:787-735-0220
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13356207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020093Medicare PIN