Provider Demographics
NPI:1487101176
Name:GUANTE, ANGEL DANIEL
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:DANIEL
Last Name:GUANTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EE18 CALLE 29
Mailing Address - Street 2:URB CANA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:787-674-0785
Mailing Address - Fax:
Practice Address - Street 1:400 AVE ROOSEVELT
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-764-3500
Practice Address - Fax:787-764-4011
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004931183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician