Provider Demographics
NPI:1841239639
Name:GUZMAN, YAMIL (OD)
Entity type:Individual
Prefix:DR
First Name:YAMIL
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 736
Mailing Address - Street 2:LOS VERSALLES
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0736
Mailing Address - Country:US
Mailing Address - Phone:787-646-4894
Mailing Address - Fax:787-834-3020
Practice Address - Street 1:975 AVE HOSTOS
Practice Address - Street 2:STE.2100
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1251
Practice Address - Country:US
Practice Address - Phone:787-834-2280
Practice Address - Fax:787-834-3020
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR476-068152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist