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NPI Code Detail

MEDICARE: ULISES A GUZMAN DDS PA

MEDICARE: ULISES A GUZMAN DDS PA
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
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN13659FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982070215
Entity Type Code : Organization
Provider Name (Legal Business Name) : ULISES A GUZMAN DDS PA
Provider Business Mailing Address
First Line : 6907 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33634-2213
Country : US
Telephone Number : 813-887-5555
Fax Number : 813-887-5556
Provider Business Practice Location Address
First Line : 6907 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33634-2213
Country : US
Telephone Number : 813-887-5555
Fax Number : 813-887-5556
Authorized Official
Title or Position : PRESIDENT
Name : DR. ULISES ANTONIO GUZMAN
Credential : DDS
Telephone Number : 813-887-5555
Provider Enumeration Date : 08/21/2015
Last Update Date : 08/21/2015

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Directions to “ULISES A GUZMAN DDS PA ” Practice Location

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