Healthcare Provider Details

I. General information

NPI: 1174955041
Provider Name (Legal Business Name): EDUARDO P GUZMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8525 SW 92ND ST BLDG A SUITE 3B
MIAMI FL
33156-7365
US

IV. Provider business mailing address

8525 SW 92ND ST BLDG A SUITE 3B
MIAMI FL
33156-7365
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-1556
  • Fax:
Mailing address:
  • Phone: 305-595-1556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN13225
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: