Individual provider Active NPI

Reinaldo Rosario Guardiola, M.D.

  • Dermatology Physician
  • San Juan, PR
National Provider Identifier
1043234941
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4262 Issued in PR
Practice address
652 Ave Munoz Rivera
Suite 3170
San Juan, PR 00918-4257
Phone
(787) 765-2305
Fax
(787) 764-1359
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4262 PR Primary

Addresses

Primary practice location

652 Ave Munoz Rivera
Suite 3170
San Juan, PR 00918-4257

Mailing address

652 Ave Munoz Rivera
Suite 3170
San Juan, PR 00918-4257
Phone (787) 765-2305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000824 PR Practitioner - Dermatology 5193908358 Practice locations: San Juan, PR; Guayama, PR

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Puerto Rico School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

282 Ave Jesus T Pinero
Suite 207
San Juan, PR 00927-3917
Phone (787) 765-2305

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions106
Skin biopsy67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4262PRMDDermatology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043234941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 AVE MUNOZ RIVERA",
            "address_2": "SUITE 3170",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184257",
            "telephone_number": "787-765-2305",
            "fax_number": "787-764-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 AVE MUNOZ RIVERA",
            "address_2": "SUITE 3170",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184257",
            "telephone_number": "787-765-2305",
            "fax_number": "787-764-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO GUARDIOLA",
        "first_name": "REINALDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "4262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.