Provider Demographics
NPI:1295700284
Name:GUZMAN-VIRELLA, JOSE R (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:GUZMAN-VIRELLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:193 DORADO BCH E
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-2211
Mailing Address - Country:US
Mailing Address - Phone:787-785-6150
Mailing Address - Fax:787-269-2669
Practice Address - Street 1:66 CALLE SANTA CRUZ STE 402
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7049
Practice Address - Country:US
Practice Address - Phone:787-785-6150
Practice Address - Fax:787-269-2669
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2010-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR6029208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79672Medicare UPIN