Provider Demographics
NPI:1962424267
Name:GUZMAN, ANGELICA (M D)
Entity type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1496
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1496
Mailing Address - Country:US
Mailing Address - Phone:787-833-0348
Mailing Address - Fax:787-805-0710
Practice Address - Street 1:EDIF LA PALMA
Practice Address - Street 2:SUITE 2A
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4861
Practice Address - Country:US
Practice Address - Phone:787-833-0348
Practice Address - Fax:787-805-0710
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3389207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF86898Medicare UPIN
PR24537Medicare ID - Type Unspecified