Provider Demographics
NPI:1619859154
Name:ORTIZ GUEVARA, DAWIN A (LIC)
Entity type:Individual
Prefix:MR
First Name:DAWIN
Middle Name:A
Last Name:ORTIZ GUEVARA
Suffix:
Gender:M
Credentials:LIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR1 BOX 10022
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720
Mailing Address - Country:US
Mailing Address - Phone:787-202-3051
Mailing Address - Fax:
Practice Address - Street 1:CARR 156 KM 1.8 INT
Practice Address - Street 2:
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720
Practice Address - Country:US
Practice Address - Phone:787-202-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8483103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling