Healthcare Provider Details

I. General information

NPI: 1477418697
Provider Name (Legal Business Name): GUIDER HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 E BRANDON BLVD # 5752
BRANDON FL
33511-5509
US

IV. Provider business mailing address

7901 4TH ST N
ST PETERSBURG FL
33702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 713-449-3536
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: KANWAL QIDWAI
Title or Position: OWNER
Credential: MD
Phone: 713-449-3536