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General NPI Number Information
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NPI Number | 1043027501
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Entity Type | Individual
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Provider Name | DEREK GUYNN APRN
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Gender | Male
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 1925 MIZELL AVE STE 201
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City | WINTER PARK
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State | FL
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Zip | 32792-4155
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Country | US
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Telephone | 407-646-7015
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Fax | 407-646-7935
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Provider Business Mailing Address
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Address Line | 1925 MIZELL AVE STE 201
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City | WINTER PARK
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State | FL
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Zip | 32792-4155
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Country | US
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Telephone | 407-646-7015
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Fax | 407-646-7935
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11036673
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License Number State | FL
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