Healthcare Provider Details

I. General information

NPI: 1912849563
Provider Name (Legal Business Name): GUARDIAN ANGEL RESEARCH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8011 N HIMES AVE STE 2
TAMPA FL
33614-2700
US

IV. Provider business mailing address

8011 N HIMES AVE STE 2
TAMPA FL
33614-2700
US

V. Phone/Fax

Practice location:
  • Phone: 813-512-7479
  • Fax: 813-304-0790
Mailing address:
  • Phone: 813-512-7479
  • Fax: 813-304-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. SUREMYS VILLEGAS PEREZ
Title or Position: PRESIDENT
Credential:
Phone: 813-512-7479