Provider Demographics
NPI:1689665325
Name:GUERRERO-JIMENEZ, MANUEL EMILIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:EMILIO
Last Name:GUERRERO-JIMENEZ
Suffix:
Gender:M
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:CALLE 4 B-16 ESTANCIAS DE SAN FERNANDO
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-757-6043
Mailing Address - Fax:
Practice Address - Street 1:CALLE 19 LOCAL 4
Practice Address - Street 2:LAS PALMAS VILLAS
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962
Practice Address - Country:US
Practice Address - Phone:787-788-5297
Practice Address - Fax:787-788-5297
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11213208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084437Medicare ID - Type Unspecified