Provider Demographics
NPI:1891706750
Name:GUERRA PRADOS, HECTOR JUAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:JUAN
Last Name:GUERRA PRADOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 CALLE BARRACUDA
Mailing Address - Street 2:BAHIA VISTAMAR
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1451
Mailing Address - Country:US
Mailing Address - Phone:787-768-5501
Mailing Address - Fax:787-768-8094
Practice Address - Street 1:1432 CALLE BARRACUDA
Practice Address - Street 2:BAHIA VISTAMAR
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-1451
Practice Address - Country:US
Practice Address - Phone:787-768-5501
Practice Address - Fax:787-768-8094
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00318103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRR91842Medicare UPIN