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General NPI Number Information
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NPI Number | 1821015652
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Entity Type | Individual
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Provider Name | NARONGSAK GUEVARA BOONSWANG MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 2380 HARBOR BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5024
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Country | US
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Telephone | 941-206-0325
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Fax | 941-766-0423
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Provider Business Mailing Address
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Address Line | 85 MCNAUGHTEN RD SUITE 110
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City | COLUMBUS
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State | OH
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Zip | 43213-2174
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Country | US
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Telephone | 614-751-8846
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Fax | 614-751-8894
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | ME130413
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MD418882
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 54194
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 77362
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License Number State | MT
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Taxonomy #5
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 35-126473
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License Number State | OH
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