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General NPI Number Information
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NPI Number | 1114366937
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Entity Type | Organization
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Legal Business Name | CHRISTINA M DE GUIA, MD PLLC
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Dates
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Enumeration Date | 06/15/2013
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 269 S OSPREY AVE STE 200
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City | SARASOTA
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State | FL
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Zip | 34236-6805
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Country | US
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Telephone | 434-242-1128
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Fax |
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Provider Business Mailing Address
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Address Line | 269 S OSPREY AVE SUITE 200
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City | SARASOTA
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State | FL
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Zip | 34236-6805
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Country | US
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Telephone | 941-364-3629
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Fax | 941-227-4724
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Authorized Official
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Title or Position | CHILD AND ADOLESCENT PSYCHIATRIST
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Name | DR. CHRISTINA MOSQUITO DE GUIA
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Credential | MD
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Telephone | 434-242-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | ME111114
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License Number State | FL
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