Provider Demographics
NPI:1760475503
Name:GUZMAN, WILMA M (PHARM D)
Entity type:Individual
Prefix:DR
First Name:WILMA
Middle Name:M
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 CALLE ESMERALDA
Mailing Address - Street 2:URB PASEO REAL
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-796-7066
Mailing Address - Fax:787-816-1824
Practice Address - Street 1:LIRIO DEL MAR
Practice Address - Street 2:C-10 DORADO DEL MAR
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-796-7066
Practice Address - Fax:787-816-1824
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS-28382183500000X
PR3-05-0044461835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist