Provider Demographics
NPI:1710863527
Name:GUZMAN TAPIA, PEDRO
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:GUZMAN TAPIA
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 1:1112 CALLE GUADALAJARA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1641
Mailing Address - Country:US
Mailing Address - Phone:787-547-0482
Mailing Address - Fax:
Practice Address - Street 1:1001 AVE PONCE DE LEON STE 1
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3641
Practice Address - Country:US
Practice Address - Phone:954-231-5484
Practice Address - Fax:239-379-4385
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4220364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist