Provider Demographics
NPI:1396753208
Name:HERNANDEZ-GUASCH, RAYDA NANETTE (MD)
Entity type:Individual
Prefix:MRS
First Name:RAYDA
Middle Name:NANETTE
Last Name:HERNANDEZ-GUASCH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PMB 525
Mailing Address - Street 2:#89 DE DIEGO AVE SUITE 105
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-5831
Mailing Address - Country:US
Mailing Address - Phone:787-269-2250
Mailing Address - Fax:787-269-2295
Practice Address - Street 1:SANTA CRUZ ST #64
Practice Address - Street 2:GALERIA MEDICA SUITE 104
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7001
Practice Address - Country:US
Practice Address - Phone:787-269-2250
Practice Address - Fax:787-269-2295
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR74932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0081524Medicare ID - Type Unspecified
G41059Medicare UPIN