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General NPI Number Information
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NPI Number | 1023540507
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Entity Type | Individual
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Provider Name | FLORENDA DE GUZMAN
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Gender | Female
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 405 N TOM GREEN
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City | ODESSA
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State | TX
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Zip | 79761
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Country | US
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Telephone | 432-580-9876
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Fax | 432-580-9877
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Provider Business Mailing Address
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Address Line | 1619 E EVERGLADE AVE
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City | ODESSA
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State | TX
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Zip | 79762-7916
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Country | US
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Telephone | 432-580-9876
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Fax | 432-580-9877
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP132916
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License Number State | TX
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