Healthcare Provider Details

I. General information

NPI: 1942419783
Provider Name (Legal Business Name): CHRISTINA M. DE GUIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 S OSPREY AVE SUITE 200
SARASOTA FL
34236-6805
US

IV. Provider business mailing address

1445 S OSPREY AVE STE 2
SARASOTA FL
34239-2920
US

V. Phone/Fax

Practice location:
  • Phone: 941-364-3629
  • Fax: 941-227-4724
Mailing address:
  • Phone: 941-364-3629
  • Fax: 941-227-4724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number245726-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME111114
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME111114
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: