Provider Demographics
NPI:1033955257
Name:GUICHARDO, NADIA ESTEFANIA (MD)
Entity type:Individual
Prefix:DR
First Name:NADIA
Middle Name:ESTEFANIA
Last Name:GUICHARDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 CALLE COLINA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4125
Mailing Address - Country:US
Mailing Address - Phone:787-400-4830
Mailing Address - Fax:
Practice Address - Street 1:2122 CALLE COLINA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4125
Practice Address - Country:US
Practice Address - Phone:787-400-4830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16576I207Q00000X
PR24026208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine