MEDICARE: RUBEN GUZMAN MD PA

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1629380928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUBEN GUZMAN MD PA

Provider Business Mailing Address
First Line	:	22099 ELMIRA BLVD
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-7018
Country	:	US
Telephone Number	:	941-766-0400
Fax Number	:	941-766-1009

Provider Business Practice Location Address
First Line	:	22099 ELMIRA BLVD
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-7018
Country	:	US
Telephone Number	:	941-766-0400
Fax Number	:	941-766-1009

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. RUBEN GUZMAN
Credential	:	MD
Telephone Number	:	941-766-0400

Provider Enumeration Date	:	07/02/2010
Last Update Date	:	07/02/2010

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