Provider Demographics
NPI:1366429078
Name:GUZMAN-NIEVES, DAVID (PHT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:GUZMAN-NIEVES
Suffix:
Gender:F
Credentials:PHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:RESIDENCIAL LOPEZ NUSSA
Mailing Address - Street 2:BLQ 1 APT 9
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-642-7624
Mailing Address - Fax:787-841-5551
Practice Address - Street 1:553 CALLE RAMOS ANTONINI
Practice Address - Street 2:EL TUQUE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-4806
Practice Address - Country:US
Practice Address - Phone:787-844-2805
Practice Address - Fax:787-841-5551
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR3078183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3078OtherPHARMACY TECHNICIAN