MEDICARE: EDISSON GUAMAN

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	363A00000X	Physician Assistant	9110396	FL

General Provider Information

NPI Number	:	1710348024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDISSON GUAMAN

Provider Business Mailing Address
First Line	:	12373 COLONY PRESERVE DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-5807
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12373 COLONY PRESERVE DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-5807
Country	:	US
Telephone Number	:	561-617-0686
Fax Number	:

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

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	10/03/2023

Similar Medicare Providers

1437410362 — MYRIANNE PYRAM KNOX
Practice Location Address:

12221 COLONY PRESERVE DR
BOYNTON BEACH, FL
33436-5807

Practice Phone: 305-336-9923
Practice Fax:

1598152480 — MARTINE PHILIPPE
Practice Location Address:

12293 COLONY PRESERVE DR
BOYNTON BEACH, FL
33436-5807

Practice Phone: 561-396-0108
Practice Fax:

1659813855 — ALBA EVELICIA BRITTON CRNA
Practice Location Address:

12213 COLONY PRESERVE DR
BOYNTON BEACH, FL
33436-5807

Practice Phone: 786-239-2689
Practice Fax:

1073299079 — 4A SURGICAL SERVICES, LLC
Practice Location Address:

12373 COLONY PRESERVE DR
BOYNTON BEACH, FL
33436-5807

Practice Phone: 561-617-0686
Practice Fax:

1730356130 — MS. LEILANI BAUTISTA FRANDO PT
Practice Location Address:

3110 E MARIQUITA ST
LONG BEACH, CA
90803-5807

Practice Phone: 562-438-8836
Practice Fax:

1508198029 — NO WAKE ZONE
Practice Location Address:

4133 PERIDOT DR
VIRGINIA BEACH, VA
23456-5807

Practice Phone: 757-286-8030
Practice Fax:

Directions to “ EDISSON GUAMAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.