MEDICARE: LESLIE GUZMAN RD

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	133VN1005X	Renal Nutrition Registered Dietitian		AZ

General Provider Information

NPI Number	:	1669322731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE GUZMAN RD

Provider Business Mailing Address
First Line	:	1086 W SCHAFER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-1528
Country	:	US
Telephone Number	:	520-609-9705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1086 W SCHAFER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-1528
Country	:	US
Telephone Number	:	520-609-9705
Fax Number	:

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

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “ LESLIE GUZMAN RD” Practice Location

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