Provider Demographics
NPI:1881275303
Name:GUZMAN PEREZ, WILMARIE
Entity type:Individual
Prefix:
First Name:WILMARIE
Middle Name:
Last Name:GUZMAN PEREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 HACIENDA LA QUINTA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-5736
Mailing Address - Country:US
Mailing Address - Phone:787-597-7650
Mailing Address - Fax:
Practice Address - Street 1:88 CARR. 2
Practice Address - Street 2:APT, SUITE, FLOOR, ETC.
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-597-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0013170183500000X
PR6255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist