MEDICARE: LUISA MARIA GUZMAN MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	ME139976	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
2	ME139976	OTHER	FL	MEDICAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396197455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUISA MARIA GUZMAN MD

Provider Business Mailing Address
First Line	:	6100 BLUE LAGOON DR STE 365
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-7010
Country	:	US
Telephone Number	:	786-322-7333
Fax Number	:

Provider Business Practice Location Address
First Line	:	3520 W 18TH AVE STE 115
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4634
Country	:	US
Telephone Number	:	786-837-0897
Fax Number	:	786-837-0898

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

Provider Enumeration Date	:	07/12/2016
Last Update Date	:	01/21/2021

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Directions to “ LUISA MARIA GUZMAN MD” Practice Location

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