Provider Demographics
NPI:1003987793
Name:GUZMAN-HERNANDEZ, BORIS M (MD)
Entity Type:Individual
Prefix:
First Name:BORIS
Middle Name:M
Last Name:GUZMAN-HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MQ10 PLAZA 37
Mailing Address - Street 2:MONTE CLARO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3577
Mailing Address - Country:US
Mailing Address - Phone:787-245-8870
Mailing Address - Fax:787-858-0434
Practice Address - Street 1:MQ10 PLAZA 37
Practice Address - Street 2:MONTE CLARO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3577
Practice Address - Country:US
Practice Address - Phone:787-245-8870
Practice Address - Fax:787-858-0434
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine