Provider Demographics
NPI:1538332614
Name:GUERRA, LYDIA E I
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:E
Last Name:GUERRA
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1269
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677
Mailing Address - Country:US
Mailing Address - Phone:787-610-7839
Mailing Address - Fax:787-823-2367
Practice Address - Street 1:CARR 414 KM 1.2
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677-1269
Practice Address - Country:US
Practice Address - Phone:787-610-7839
Practice Address - Fax:787-823-2367
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR024047163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse