Healthcare Provider Details

I. General information

NPI: 1689466013
Provider Name (Legal Business Name): DR. EDUARDO ANTONIO GUIZAN CORRALES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

3140 SW 12TH ST APT 1
MIAMI FL
33135-4747
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-1960
  • Fax:
Mailing address:
  • Phone: 786-470-7161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS59920
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: