MEDICARE: MARTHA ISABEL GUZMAN R.PH.

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	183500000X	Pharmacist	30931	FL

General Provider Information

NPI Number	:	1477534568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA ISABEL GUZMAN R.PH.

Provider Business Mailing Address
First Line	:	14829 CORAL BERRY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2353
Country	:	US
Telephone Number	:	813-629-8822
Fax Number	:	813-354-3417

Provider Business Practice Location Address
First Line	:	8000 N ARMENIA AVE
Second Line	:	SUITE G
City	:	TAMPA
State	:	FL
Zip	:	33604-2758
Country	:	US
Telephone Number	:	813-629-8822
Fax Number	:	813-354-3417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	06/15/2010

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