Provider Demographics
NPI:1023091188
Name:GUERRERO RODRIGUEZ, LEONEL ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:LEONEL
Middle Name:ENRIQUE
Last Name:GUERRERO RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:20 AVE LUIS MUNOZ MARIN
Mailing Address - Street 2:PMB 536 URB VILLA BLANCA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-308-5846
Mailing Address - Fax:787-860-0947
Practice Address - Street 1:TORRE SAN PABLO DEL ESTE, SUITE 401
Practice Address - Street 2:AVE. GENERAL VALERO # 410
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-655-0505
Practice Address - Fax:787-863-1212
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14100208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-34813Medicare UPIN
PR2-3280Medicare ID - Type Unspecified