MEDICARE: DR. MONICA SAMIR GUIRGUIS D.O.

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	208000000X	Pediatrics Physician	5101020750	MI
2	208000000X	Pediatrics Physician	OS14097	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295174449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONICA SAMIR GUIRGUIS D.O.

Provider Business Mailing Address
First Line	:	1135 E STATE ROAD 434 STE 1001
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2744
Country	:	US
Telephone Number	:	407-635-3320
Fax Number	:	407-636-7843

Provider Business Practice Location Address
First Line	:	1135 E STATE ROAD 434 STE 1001
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2744
Country	:	US
Telephone Number	:	407-635-3320
Fax Number	:	407-636-7843

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

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	05/22/2020

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