Provider Demographics
NPI:1215200985
Name:GUZMAN PISFIL, PEDRO BALTAZAR (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:BALTAZAR
Last Name:GUZMAN PISFIL
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:CALLE 10 B 17-8
Mailing Address - Street 2:URB. SANTA ROSA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-387-7640
Mailing Address - Fax:
Practice Address - Street 1:59 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6900
Practice Address - Country:US
Practice Address - Phone:787-778-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18389208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice