Healthcare Provider Details
I. General information
NPI: 1487622023
Provider Name (Legal Business Name): ALLISON GUYEN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/09/2006
Last Update Date: 08/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4308 ALTON RD SUITE 710
MIAMI BEACH FL
33140-4556
US
IV. Provider business mailing address
2020 N BAYSHORE DR APT 2009
MIAMI FL
33137-5167
US
V. Phone/Fax
- Phone: 305-695-7777
- Fax: 305-695-7707
- Phone: 305-695-7777
- Fax: 305-695-7707
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | MD002580 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | MD002580 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | MD002580 |
| License Number State | NJ |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | PO 3525 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: