MEDICARE: GUIDEWELL SANITAS I, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1033697081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDEWELL SANITAS I, LLC

Provider Business Mailing Address
First Line	:	8400 NW 33RD ST STE 201
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33122-1937
Country	:	US
Telephone Number	:	786-882-2869
Fax Number	:

Provider Business Practice Location Address
First Line	:	5160 S JOHN YOUNG PKWY BAY 5190
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-5022
Country	:	US
Telephone Number	:	305-470-2929
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MAYRA G TORRES
Credential	:
Telephone Number	:	786-648-6285

Provider Enumeration Date	:	08/01/2018
Last Update Date	:	03/31/2025

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