Provider Demographics
NPI:1598726952
Name:MAYMI GUERRA, ANDRES M (DPM)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:M
Last Name:MAYMI GUERRA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:351 HOSTOS AVE
Mailing Address - Street 2:SUITE 310 MEDICAL EMPORIUM BUILDING
Mailing Address - City:MAYAGUES
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-832-0899
Mailing Address - Fax:787-833-6434
Practice Address - Street 1:351 HOSTOS AVE
Practice Address - Street 2:SUITE 310 MEDICAL EMPORIUM BUILDING
Practice Address - City:MAYAGUES
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-0899
Practice Address - Fax:787-833-6434
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR0076213ES0131X
PR76213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0048080Medicare ID - Type Unspecified
U52255Medicare UPIN