Healthcare Provider Details

I. General information

NPI: 1063957181
Provider Name (Legal Business Name): JOSE ANDRES GUZMAN ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2016
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 NW 27TH AVE STE 130
MIAMI FL
33125-2173
US

IV. Provider business mailing address

6100 BLUE LAGOON DR
MIAMI FL
33126-3759
US

V. Phone/Fax

Practice location:
  • Phone: 305-635-7710
  • Fax: 786-621-7817
Mailing address:
  • Phone: 786-322-7333
  • Fax: 786-347-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9367692
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: