Provider Demographics
NPI:1306022512
Name:GUZMAN, MICHAEL MANUEL (MS OTL)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:MANUEL
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:MS OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 CALLE TER
Mailing Address - Street 2:URB. RIO PIEDRAS HEIGHTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3253
Mailing Address - Country:US
Mailing Address - Phone:939-639-5560
Mailing Address - Fax:
Practice Address - Street 1:1710 CALLE TER
Practice Address - Street 2:URB. RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3253
Practice Address - Country:US
Practice Address - Phone:939-639-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1075225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist