Provider Demographics
NPI:1699783191
Name:FRANK GAUDIER GUERRA MD
Entity type:Organization
Organization Name:FRANK GAUDIER GUERRA MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAUDIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-268-1015
Mailing Address - Street 1:PO BOX 11792
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-2892
Mailing Address - Country:US
Mailing Address - Phone:787-268-1015
Mailing Address - Fax:787-268-5511
Practice Address - Street 1:PAVIA MEDICAL PLAZA 611
Practice Address - Street 2:SUITE #113
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00910-2892
Practice Address - Country:US
Practice Address - Phone:787-268-1015
Practice Address - Fax:787-268-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Multi-Specialty
No2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Multi-Specialty
No2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammographyGroup - Multi-Specialty
No2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR85271Medicare PIN