Healthcare Provider Details

I. General information

NPI: 1932450301
Provider Name (Legal Business Name): MARTHA PAMELA GUEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA PAMELA CONNERS PA-C

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 N KENTUCKY AVE
WINTER PARK FL
32789-4741
US

IV. Provider business mailing address

2681 HONEY HILL RD
KNOXVILLE TN
37924-1159
US

V. Phone/Fax

Practice location:
  • Phone: 407-539-2766
  • Fax: 407-539-2786
Mailing address:
  • Phone: 128-019-9884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119619
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA055621
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: