Healthcare Provider Details

I. General information

NPI: 1720388689
Provider Name (Legal Business Name): RAMON A GUEVARA D.O.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 NW 8TH ST SUITE 110
HOMESTEAD FL
33030-4452
US

IV. Provider business mailing address

45 NW 8TH ST SUITE 110
HOMESTEAD FL
33030-4452
US

V. Phone/Fax

Practice location:
  • Phone: 305-248-1900
  • Fax: 305-248-1902
Mailing address:
  • Phone: 305-248-1900
  • Fax: 305-248-1902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS6587
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMON A GUEVARA
Title or Position: PRESIDENT
Credential: DO
Phone: 305-361-6232