Provider Demographics
NPI:1609571066
Name:ROSA GUZMAN, GUILLERMO SR (BSN)
Entity Type:Individual
Prefix:MR
First Name:GUILLERMO
Middle Name:
Last Name:ROSA GUZMAN
Suffix:SR
Gender:M
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 4631
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-8682
Mailing Address - Country:US
Mailing Address - Phone:787-233-9290
Mailing Address - Fax:
Practice Address - Street 1:CAIMITO BAJO KM 7 H 18
Practice Address - Street 2:BO. DULCE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-233-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29895163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice