Provider Demographics
NPI:1922154376
Name:GUILLONT JUARBE, SADIASEPT (MD)
Entity Type:Individual
Prefix:DR
First Name:SADIASEPT
Middle Name:
Last Name:GUILLONT JUARBE
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 1:1611 CALLE ENCARNACION
Mailing Address - Street 2:CAPARRA HEIGHTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4743
Mailing Address - Country:US
Mailing Address - Phone:787-622-3054
Mailing Address - Fax:
Practice Address - Street 1:1611 CALLE ENCARNACION
Practice Address - Street 2:CAPARRA HEIGTHS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4743
Practice Address - Country:US
Practice Address - Phone:787-622-3054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14587207V00000X, 207VG0400X, 207VM0101X, 207VX0000X, 261QA0005X, 261QA1903X, 261QF0050X, 261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH99062Medicare UPIN
PR0021315Medicare ID - Type Unspecified