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General NPI Number Information
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NPI Number | 1265189989
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Entity Type | Individual
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Provider Name | MR. KENNETH GUAY
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Gender | Male
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Dates
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Enumeration Date | 03/02/2022
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 401 CORAL WAY STE 301
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City | CORAL GABLES
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State | FL
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Zip | 33134-4926
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Country | US
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Telephone | 810-278-1392
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Fax |
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Provider Business Mailing Address
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Address Line | 9723 ZENS CT
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City | CLAY
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State | MI
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Zip | 48001-4722
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Country | US
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Telephone | 810-278-1392
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9115428
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601012691
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License Number State | MI
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