Provider Demographics
NPI:1285024224
Name:SERVICIOS MEDICOS DR. RICARDO GUERRERO, C.S.P.
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS DR. RICARDO GUERRERO, C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PM&R
Authorized Official - Phone:787-961-2893
Mailing Address - Street 1:A16 CALLE JAGUA
Mailing Address - Street 2:VALLE ARRIBA HEIGHTS
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-3423
Mailing Address - Country:US
Mailing Address - Phone:787-961-2893
Mailing Address - Fax:787-961-2893
Practice Address - Street 1:CARR. MARGINAL 187 AVE. ISLA VERDE
Practice Address - Street 2:ISLA VERDE MALL SUITE 209
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982
Practice Address - Country:US
Practice Address - Phone:787-961-2893
Practice Address - Fax:787-961-2893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16221208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHU602AOtherMEDICARE PTAN