Healthcare Provider Details

I. General information

NPI: 1467392191
Provider Name (Legal Business Name): STEPHANIE GUADARRAMA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 N DUPONT BLVD
MILFORD DE
19963-1006
US

IV. Provider business mailing address

640 S STATE ST
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-725-3557
  • Fax:
Mailing address:
  • Phone: 302-725-3557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC7-0019187
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: