Provider Demographics
NPI:1376691477
Name:GUZMAN GUZMAN, OLGA E (MD)
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:E
Last Name:GUZMAN GUZMAN
Suffix:
Gender:F
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:PO BOX 1601
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-872-0707
Mailing Address - Fax:787-280-0707
Practice Address - Street 1:101 CALLE PAVIA FERNANDEZ
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2206
Practice Address - Country:US
Practice Address - Phone:787-872-0707
Practice Address - Fax:787-280-0707
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR87616Medicare ID - Type Unspecified
G39681Medicare UPIN