| Guayama Family Practice, Llc | |
|
42 Calle Palmer S Guayama PR 00784-4922 | |
| (787) 866-0725 | |
| (787) 866-0715 |
| Full Name | Guayama Family Practice, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 42 Calle Palmer S, Guayama, Puerto Rico |
| Authorized Official Name and Position | David T Sicard Figueroa (OWNER) |
| Authorized Official Contact | 7873857655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guayama Family Practice, Llc Po Box 519 Guayama PR 00785-0519 Ph: (787) 866-0725 | Guayama Family Practice, Llc 42 Calle Palmer S Guayama PR 00784-4922 Ph: (787) 866-0725 |
| NPI Number | 1184023038 |
|---|---|
| Provider Enumeration Date | 08/16/2014 |
| Last Update Date | 08/16/2014 |
| Medicare PECOS PAC ID | 6406170984 |
|---|---|
| Medicare Enrollment ID | O20150112001552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184023038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 12075 (Puerto Rico) | Primary |
| Provider Name | David T Sicard Figueroa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639162308 PECOS PAC ID: 9739337551 Enrollment ID: I20120919000443 |
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