Provider Demographics
NPI:1124054960
Name:GUZMAN, ROSA EILIANA (MD)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:EILIANA
Last Name:GUZMAN
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:AW8 CALLE PIEDRAS NEGRAS
Mailing Address - Street 2:VENUS GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4658
Mailing Address - Country:US
Mailing Address - Phone:787-755-2084
Mailing Address - Fax:
Practice Address - Street 1:D14 AVE ROBERTO CLEMENTE
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5406
Practice Address - Country:US
Practice Address - Phone:787-762-6085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7599146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG40353Medicare UPIN