Provider Demographics
NPI:1013957224
Name:GURREA, CARMEN MARGARITA (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARGARITA
Last Name:GURREA
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:E12 CALLE MALAGA
Mailing Address - Street 2:VISTAMAR MARINA,
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1507
Mailing Address - Country:US
Mailing Address - Phone:787-721-1684
Mailing Address - Fax:787-721-1684
Practice Address - Street 1:SAN JUAN HEALTH CENTRE, SUITE 610
Practice Address - Street 2:200 DE DIEGO AVE.
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00907-2318
Practice Address - Country:US
Practice Address - Phone:787-723-1674
Practice Address - Fax:787-721-1684
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6194207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR27302Medicare ID - Type Unspecified
PRE-31488Medicare UPIN