Healthcare Provider Details

I. General information

NPI: 1316390404
Provider Name (Legal Business Name): EDGARDO J GUZMAN RIVERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 EICHENFELD DR UNIT 102
BRANDON FL
33511-5942
US

IV. Provider business mailing address

938 CYPRESS VILLAGE BLVD STE A
SUN CITY CENTER FL
33573-6835
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-5080
  • Fax: 813-773-7717
Mailing address:
  • Phone: 813-333-5080
  • Fax: 813-773-7717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME153037
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: