Healthcare Provider Details

I. General information

NPI: 1548834245
Provider Name (Legal Business Name): JONATHAN APOSTOL GUZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JONATHAN CHRISTOPHER APOSTOL GUZMAN MD

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

V. Phone/Fax

Practice location:
  • Phone: 800-432-6837
  • Fax:
Mailing address:
  • Phone: 800-432-6837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberME183778
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: