Healthcare Provider Details

I. General information

NPI: 1598093817
Provider Name (Legal Business Name): CARLOS M GUIDA M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 NW 42ND AVE STE 406
MIAMI FL
33126-5689
US

IV. Provider business mailing address

PO BOX 650220
MIAMI FL
33265-0220
US

V. Phone/Fax

Practice location:
  • Phone: 305-643-6500
  • Fax: 305-642-4995
Mailing address:
  • Phone: 305-643-6500
  • Fax: 305-642-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS M GUIDA
Title or Position: OWNER
Credential: MD
Phone: 305-643-6500