Healthcare Provider Details

I. General information

NPI: 1720517295
Provider Name (Legal Business Name): FREDDIE GUZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 03/07/2023
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 SW 1ST AVE
OCALA FL
34471-6500
US

IV. Provider business mailing address

127 HICKORY CRSE
OCALA FL
34472-4376
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-1000
  • Fax:
Mailing address:
  • Phone: 256-405-5328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number32847-R
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME143217
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: