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General NPI Number Information
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NPI Number | 1770510265
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Entity Type | Organization
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Legal Business Name | GUIDO G. URIZAR,M.D.,P.A.
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9275 SW 152ND ST
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33157-1701
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Country | US
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Telephone | 305-232-0084
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Fax |
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Provider Business Mailing Address
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Address Line | 9275 SW 152ND ST
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33157-1701
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Country | US
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Telephone | 305-232-0084
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. GUIDO GROVER URIZAR
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Credential | MD
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Telephone | 305-232-0084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME33432
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License Number State | FL
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