MEDICARE: JUAN ACOSTA GUZMAN APRN

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	363L00000X	Nurse Practitioner	APRN11010299	FL

General Provider Information

NPI Number	:	1154919603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN ACOSTA GUZMAN APRN

Provider Business Mailing Address
First Line	:	4445 W 16TH AVE STE 300
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7190
Country	:	US
Telephone Number	:	786-778-7449
Fax Number	:	786-685-3908

Provider Business Practice Location Address
First Line	:	4445 W 16TH AVE STE 300
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7190
Country	:	US
Telephone Number	:	786-234-7253
Fax Number	:

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

Provider Enumeration Date	:	01/08/2021
Last Update Date	:	06/13/2025

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