Provider Demographics
NPI:1023174083
Name:MERCEDES GUZMAN, VIRGILIO (PHARMACIST)
Entity type:Individual
Prefix:
First Name:VIRGILIO
Middle Name:
Last Name:MERCEDES GUZMAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C2 CALLE FRANCISCO GONZALEZ
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3212
Mailing Address - Country:US
Mailing Address - Phone:787-203-0460
Mailing Address - Fax:787-285-7243
Practice Address - Street 1:54 CALLE FONT MARTELO E
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3603
Practice Address - Country:US
Practice Address - Phone:787-852-0620
Practice Address - Fax:787-285-7243
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist