Healthcare Provider Details

I. General information

NPI: 1477697753
Provider Name (Legal Business Name): NORMAN DAVID GUTHRIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NE 55TH BLVD
GAINESVILLE FL
32641-2783
US

IV. Provider business mailing address

PO BOX 6961
LAKELAND FL
33807-6961
US

V. Phone/Fax

Practice location:
  • Phone: 863-398-2777
  • Fax:
Mailing address:
  • Phone: 863-398-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberME44705
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: