Healthcare Provider Details

I. General information

NPI: 1215381116
Provider Name (Legal Business Name): DEVON JERMAINE O'GUINN M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2016
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST STE 702
MIAMI FL
33136-2118
US

IV. Provider business mailing address

1150 NW 14TH ST STE 702
MIAMI FL
33136-2118
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-9808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME175539
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberV0082
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME175539
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: