Provider Demographics
NPI:1730196247
Name:GUZMAN ALVARADO, WILBERTO (M D)
Entity type:Individual
Prefix:
First Name:WILBERTO
Middle Name:
Last Name:GUZMAN ALVARADO
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 CALLE PARANA
Mailing Address - Street 2:EL CEREZAL
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3148
Mailing Address - Country:US
Mailing Address - Phone:787-766-8548
Mailing Address - Fax:787-282-0483
Practice Address - Street 1:1716 CALLE PARANA
Practice Address - Street 2:EL CEREZAL
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-3148
Practice Address - Country:US
Practice Address - Phone:787-766-8548
Practice Address - Fax:787-282-0483
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11015207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR061192OtherCRUZ AZUL
PR83716OtherTRIPLE S
PR061192OtherCRUZ AZUL
PRF74100Medicare UPIN