Provider Demographics
NPI:1144429416
Name:ULMOS, GUILLERMO E SR (MD)
Entity Type:Individual
Prefix:MR
First Name:GUILLERMO
Middle Name:E
Last Name:ULMOS
Suffix:SR
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 1:4097 STREET EMILIANO POL
Mailing Address - Street 2:SUITE 574
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-760-1262
Mailing Address - Fax:
Practice Address - Street 1:4097 STREET EMILIANO POL
Practice Address - Street 2:SUITE 574
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-760-1262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4242208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery