1003602954 NPI number — CARLOS GERARDO GUZMAN ACEVEDO PHARMD

Table of content: CARLOS GERARDO GUZMAN ACEVEDO PHARMD (NPI 1003602954)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003602954 NPI number — CARLOS GERARDO GUZMAN ACEVEDO PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUZMAN ACEVEDO
Provider First Name:
CARLOS
Provider Middle Name:
GERARDO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003602954
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
73 EDIFICIO MEDICO SANTA CRUZ
Provider Second Line Business Mailing Address:
CALLE SANTA CRUZ SUITE 101
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00961-6911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-798-4646
Provider Business Mailing Address Fax Number:
787-288-8111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 EDIFICIO MEDICO SANTA CRUZ
Provider Second Line Business Practice Location Address:
CALLE SANTA CRUZ SUITE 101
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-6911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-798-4646
Provider Business Practice Location Address Fax Number:
787-288-8111
Provider Enumeration Date:
04/17/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  8383 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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