MEDICARE: GUILLERMO LEON CHT

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	101Y00000X	Counselor	061809-1174	FL

General Provider Information

NPI Number	:	1881826808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMO LEON CHT

Provider Business Mailing Address
First Line	:	4025 N FEDERAL HWY APT 218A
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-5551
Country	:	US
Telephone Number	:	954-684-1174
Fax Number	:

Provider Business Practice Location Address
First Line	:	4025 N FEDERAL HWY APT 218A
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-5551
Country	:	US
Telephone Number	:	954-684-1174
Fax Number	:

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

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	08/10/2009

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Directions to “ GUILLERMO LEON CHT” Practice Location

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