Healthcare Provider Details

I. General information

NPI: 1699894402
Provider Name (Legal Business Name): CAMILO H GUZMAN OTRL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13342 SW 32ND STREET
MIRAMAR FL
33027
US

IV. Provider business mailing address

13342 SW 32ND STREET
MIRAMAR FL
33027
US

V. Phone/Fax

Practice location:
  • Phone: 305-742-3687
  • Fax: 954-443-5912
Mailing address:
  • Phone: 305-742-3687
  • Fax: 954-443-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT6033
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: