Provider Demographics
NPI:1982745816
Name:ABREU GUZMAN, JOSE M. (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE M.
Middle Name:
Last Name:ABREU GUZMAN
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 1:10 CALLE PATRIOTA POZO
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-5050
Mailing Address - Country:US
Mailing Address - Phone:787-633-1724
Mailing Address - Fax:787-897-5522
Practice Address - Street 1:10 CALLE PATRIOTA POZO
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5050
Practice Address - Country:US
Practice Address - Phone:787-633-1724
Practice Address - Fax:787-897-5522
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10993208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083643Medicare ID - Type Unspecified
PRG04564Medicare UPIN