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General NPI Number Information
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NPI Number | 1417760067
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Entity Type | Individual
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Provider Name | RAQUEL TERESA GUZMAN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 25325 RAMPART BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33983-6404
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Country | US
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Telephone | 941-629-7466
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Fax | 941-629-9053
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Provider Business Mailing Address
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Address Line | 28058 ARROWHEAD CIR
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City | PUNTA GORDA
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State | FL
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Zip | 33982-4806
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Country | US
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Telephone | 727-458-7237
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 25860
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License Number State | FL
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