Provider Demographics
NPI:1417837956
Name:EDMONDS GUZMAN, LILLIANA
Entity type:Individual
Prefix:
First Name:LILLIANA
Middle Name:
Last Name:EDMONDS GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 CALLE MAXIMILIANO REYES
Mailing Address - Street 2:
Mailing Address - City:AGUIRRE
Mailing Address - State:PR
Mailing Address - Zip Code:00704-2823
Mailing Address - Country:US
Mailing Address - Phone:787-553-8204
Mailing Address - Fax:
Practice Address - Street 1:793 CALLE MAXIMILIANO REYES
Practice Address - Street 2:
Practice Address - City:AGUIRRE
Practice Address - State:PR
Practice Address - Zip Code:00704-2823
Practice Address - Country:US
Practice Address - Phone:787-553-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001832225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Single Specialty