Provider Demographics
NPI:1699820605
Name:MENDEZ DE GUZMAN, ANGELA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:MENDEZ DE 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 1:14 CALLE G
Mailing Address - Street 2:VILLA CAPARRA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1733
Mailing Address - Country:US
Mailing Address - Phone:787-385-2028
Mailing Address - Fax:787-727-1477
Practice Address - Street 1:14 CALLE G
Practice Address - Street 2:VILLA CAPARRA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1733
Practice Address - Country:US
Practice Address - Phone:787-385-2028
Practice Address - Fax:787-727-1477
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR83502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8350OtherRADIOLOGIST