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1366056327 NPI number — GUSTAVO ANTONIO GUZMAN SANJURJO LMHC

NPI Number: 1366056327
Health Care Provider/Practitioner: GUSTAVO ANTONIO GUZMAN SANJURJO LMHC

Information about “1366056327” NPI (GUSTAVO ANTONIO GUZMAN SANJURJO LMHC) exists in 1366056327 in HTML format HTML  |  1366056327 in plain Text format TXT  |  1366056327 in PDF (Portable Document Format) PDF  |  1366056327 in an XML format XML  formats.

NPI Number : 1366056327 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366056327",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GUZMAN SANJURJO",
    "FirstName": "GUSTAVO",
    "MiddleName": "ANTONIO",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "LMHC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "16A PROSPERITY LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALM COAST",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32164-7409",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "407-450-5985",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "303 COMMERCE CENTER DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT CLOUD",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34769-1549",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "407-450-5985",
    "PracticeLocationAddressFaxNumber": "407-604-6883",
    "EnumerationDate": "09/06/2020",
    "LastUpdateDate": "03/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YS0200X",
          "TaxonomyName": "School Counselor",
          "LicenseNumber": "MH18306",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "MH18306",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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