Healthcare Provider Details

I. General information

NPI: 1568354660
Provider Name (Legal Business Name): BG PRIVACY RESEARCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 NW 114TH AVE UNIT 22
DORAL FL
33178-4373
US

IV. Provider business mailing address

4005 NW 114TH AVE UNIT 224005NW
DORAL FL
33178-4374
US

V. Phone/Fax

Practice location:
  • Phone: 305-260-6913
  • Fax: 786-999-8805
Mailing address:
  • Phone: 305-260-6913
  • Fax: 786-999-8805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERNESTO GUEVARA
Title or Position: OWNER
Credential:
Phone: 786-366-2050