1215599808 NPI number — CAROLINA ELMIRE GUERRERO DIAZ MD

Table of content: CAROLINA ELMIRE GUERRERO DIAZ MD (NPI 1215599808)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215599808 NPI number — CAROLINA ELMIRE GUERRERO DIAZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUERRERO DIAZ
Provider First Name:
CAROLINA
Provider Middle Name:
ELMIRE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1215599808
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
D30 CALLE 8
Provider Second Line Business Mailing Address:
PASEO MAYOR
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-365-6416
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY OF NEBRASKA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
982161 NEBRASKA MEDICAL CENTER
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68198-2185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-559-5380
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2019

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: 208000000X , with the licence number:  35464-R , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: 35464-R , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 22789 , 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)