Provider Demographics
NPI:1699228114
Name:UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Entity type:Organization
Organization Name:UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGERY RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALANNA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MSC
Authorized Official - Phone:973-474-6640
Mailing Address - Street 1:1026 AVE LUIS VIGOREAUX
Mailing Address - Street 2:APT 11A
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2506
Mailing Address - Country:US
Mailing Address - Phone:973-474-6640
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-763-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No282NC2000XHospitalsGeneral Acute Care HospitalChildren
No2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital