Healthcare Provider Details

I. General information

NPI: 1295603983
Provider Name (Legal Business Name): TANIA ISABEL GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2025
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14261 COMMERCE WAY STE 203
MIAMI LAKES FL
33016-1647
US

IV. Provider business mailing address

14261 COMMERCE WAY STE 203
MIAMI LAKES FL
33016-1647
US

V. Phone/Fax

Practice location:
  • Phone: 305-698-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11042959
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: