Healthcare Provider Details

I. General information

NPI: 1225605991
Provider Name (Legal Business Name): GEORGES ISAAC GUILLAUME MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 BOSTON AVE
ALTAMONTE SPRINGS FL
32701-4798
US

IV. Provider business mailing address

160 BOSTON AVE
ALTAMONTE SPRINGS FL
32701-4798
US

V. Phone/Fax

Practice location:
  • Phone: 407-775-7654
  • Fax: 407-834-0609
Mailing address:
  • Phone: 407-775-7654
  • Fax: 407-834-0609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME175334
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: