MEDICARE: MARCELA D GUZMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN16736	FL

General Provider Information

NPI Number	:	1124296256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCELA D GUZMAN DDS

Provider Business Mailing Address
First Line	:	1014 BUENAVENTURA BLVD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34743-7865
Country	:	US
Telephone Number	:	407-344-2400
Fax Number	:	407-344-1728

Provider Business Practice Location Address
First Line	:	10045 OAKSIDE CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-5938
Country	:	US
Telephone Number	:	407-370-3236
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	04/08/2016

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