Provider Demographics
NPI:1821987918
Name:GUERRERO-THILLET, KALYAN AMANI
Entity type:Individual
Prefix:
First Name:KALYAN
Middle Name:AMANI
Last Name:GUERRERO-THILLET
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:LAKESIDE VILLAS
Mailing Address - Street 2:N5
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:US
Mailing Address - Phone:443-469-1002
Mailing Address - Fax:
Practice Address - Street 1:7 CALLE TABONUCO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3002
Practice Address - Country:US
Practice Address - Phone:443-469-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1140225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist