Healthcare Provider Details
I. General information
NPI: 1639114267
Provider Name (Legal Business Name): DR. ROWENA GUZMAN UY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/18/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5325 GREENWOOD AVE SUITE #302
WEST PALM BEACH FL
33407-2452
US
IV. Provider business mailing address
5325 GREENWOOD AVE SUITE #302
WEST PALM BEACH FL
33407-2452
US
V. Phone/Fax
- Phone: 561-844-9858
- Fax: 561-844-3436
- Phone: 561-844-9858
- Fax: 561-844-3436
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | ME 92057 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: