Healthcare Provider Details

I. General information

NPI: 1285606442
Provider Name (Legal Business Name): ANDREW M GUZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 75TH ST W
BRADENTON FL
34209-3201
US

IV. Provider business mailing address

315 75TH ST W
BRADENTON FL
34209-3201
US

V. Phone/Fax

Practice location:
  • Phone: 941-752-2025
  • Fax: 855-817-7456
Mailing address:
  • Phone: 941-752-2025
  • Fax: 855-817-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036112905
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME113678
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: