Basic Information
| Provider Information | |||||||||
| NPI: | 1821212424 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAZARIO GUIRAU | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | ANTONIO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD,GS,FABWH,FACHM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 364581 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009364581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875056076 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | AVENIDA PONCE DE LEON # 715 | ||||||||
| Address2: | HOSPITAL AUXILIO MUTUO | ||||||||
| City: | HATO REY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 05/15/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 8131 | PR | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.