Provider Demographics
NPI:1073500328
Name:GUTHRIE, TROY H JR (MD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:H
Last Name:GUTHRIE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1410
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:425 N LEE ST STE 204
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204
Practice Address - Country:US
Practice Address - Phone:904-427-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66255207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4402739OtherAETNA
GA000643574DMedicaid
FLP01405056OtherRR MEDICARE
FL1100398OtherCAREPLUS
FL12687OtherBCBS
FL1193085OtherWELLCARE
FL1614130OtherCIGNA
FL208075OtherAVMED
FL0533629-00Medicaid
FLP01756757OtherRR MEDICARE
FLP01756757OtherRR MEDICARE
FL1100398OtherCAREPLUS
FLIA064ZMedicare PIN
FL12687UMedicare UPIN
FL0533629-00Medicaid