Healthcare Provider Details

I. General information

NPI: 1245785682
Provider Name (Legal Business Name): CHRISTINA LALLY GUZY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11388 SW 110TH LN
MIAMI FL
33176-3155
US

IV. Provider business mailing address

11388 SW 110TH LN
MIAMI FL
33176-3155
US

V. Phone/Fax

Practice location:
  • Phone: 305-772-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ7806
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA15562
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: