Provider Demographics
NPI:1760955744
Name:GUZMAN MOYETT, FELIX G
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:G
Last Name:GUZMAN MOYETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE BETANCES
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-3647
Mailing Address - Country:US
Mailing Address - Phone:787-267-4994
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3647
Practice Address - Country:US
Practice Address - Phone:787-267-4994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3559103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical