MEDICARE: GIANINA GUEVARA

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	225700000X	Massage Therapist	MA53404

General Provider Information

NPI Number	:	1922631183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIANINA GUEVARA

Provider Business Mailing Address
First Line	:	4184 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6429
Country	:	US
Telephone Number	:	813-402-2079
Fax Number	:

Provider Business Practice Location Address
First Line	:	4184 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6429
Country	:	US
Telephone Number	:	813-402-2079
Fax Number	:

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

Provider Enumeration Date	:	02/17/2020
Last Update Date	:	02/17/2020

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Directions to “ GIANINA GUEVARA ” Practice Location

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