1023091188 NPI number — LEONEL ENRIQUE GUERRERO RODRIGUEZ M.D.

Table of content: LEONEL ENRIQUE GUERRERO RODRIGUEZ M.D. (NPI 1023091188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023091188 NPI number — LEONEL ENRIQUE GUERRERO RODRIGUEZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUERRERO RODRIGUEZ
Provider First Name:
LEONEL
Provider Middle Name:
ENRIQUE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1023091188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 AVE LUIS MUNOZ MARIN
Provider Second Line Business Mailing Address:
PMB 536 URB VILLA BLANCA
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00725
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-308-5846
Provider Business Mailing Address Fax Number:
787-860-0947

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TORRE SAN PABLO DEL ESTE, SUITE 401
Provider Second Line Business Practice Location Address:
AVE. GENERAL VALERO # 410
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-655-0505
Provider Business Practice Location Address Fax Number:
787-863-1212
Provider Enumeration Date:
11/22/2005

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: 208800000X , with the licence number:  14100 , 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)





Copyright © 2007-2025 www.npivalidator.com