Healthcare Provider Details

I. General information

NPI: 1881566503
Provider Name (Legal Business Name): VICTOR LUIS GUZMAN REYNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 10/24/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 W 68TH ST APT 417
HIALEAH FL
33014-5133
US

IV. Provider business mailing address

1075 W 68TH ST APT 417
HIALEAH FL
33014-5133
US

V. Phone/Fax

Practice location:
  • Phone: 305-407-7717
  • Fax:
Mailing address:
  • Phone: 305-407-7717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: