Provider Demographics
NPI:1821180647
Name:GUZMAN VILLARONGA, JORGE L (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:L
Last Name:GUZMAN VILLARONGA
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 1:1 CALLE TAINA
Mailing Address - Street 2:PARQUES DE BUCARE II
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5119
Mailing Address - Country:US
Mailing Address - Phone:787-789-0882
Mailing Address - Fax:787-789-0882
Practice Address - Street 1:HOSPITAL DAMAS
Practice Address - Street 2:2213 PONCE BYPASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1318
Practice Address - Country:US
Practice Address - Phone:787-840-8655
Practice Address - Fax:787-789-0882
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8870207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR80360Medicare ID - Type UnspecifiedPROVIDER NUMBER
PRE43432Medicare UPIN