Provider Demographics
NPI:1932291051
Name:GUZMAN MALDONADO, YANNETTE (MD)
Entity Type:Individual
Prefix:MISS
First Name:YANNETTE
Middle Name:
Last Name:GUZMAN MALDONADO
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:BOX 180
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783
Mailing Address - Country:US
Mailing Address - Phone:787-870-4583
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 49 5
Practice Address - Street 2:PROFESSIONAL HOSPITAL
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-0505
Practice Address - Fax:787-884-0510
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15742208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice