Provider Demographics
NPI:1801810700
Name:GUERRERO, JUAN ISIDRO (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:ISIDRO
Last Name:GUERRERO
Suffix:
Gender:M
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:D10 CALLE JAZMIN
Mailing Address - Street 2:HC3 BOX 7586
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-2018
Mailing Address - Country:US
Mailing Address - Phone:787-376-9443
Mailing Address - Fax:787-875-4904
Practice Address - Street 1:D10 CALLE JAZMIN
Practice Address - Street 2:HC3 BOX 7586
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-2018
Practice Address - Country:US
Practice Address - Phone:787-376-9443
Practice Address - Fax:787-875-4904
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14039208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-1208Medicare ID - Type Unspecified