Healthcare Provider Details

I. General information

NPI: 1598411662
Provider Name (Legal Business Name): FGUYER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2022
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 E IRLO BRONSON MEMORIAL HWY
SAINT CLOUD FL
34771-5821
US

IV. Provider business mailing address

8377 CORKFIELD AVE
ORLANDO FL
32832-5008
US

V. Phone/Fax

Practice location:
  • Phone: 888-891-7004
  • Fax:
Mailing address:
  • Phone: 608-217-7768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SLEEM F'GUYER
Title or Position: CEO
Credential: MD
Phone: 608-217-7768