Provider Demographics
NPI:1649033325
Name:REQUEJO FIGUEROA, GUILLERMO ANDRES
Entity type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:ANDRES
Last Name:REQUEJO FIGUEROA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CIUDAD JARDIN CALLE ALAMO 22
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-340-3617
Mailing Address - Fax:
Practice Address - Street 1:CIUDAD JARDIN CALLE ALAMO 22
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-340-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program