Provider Demographics
NPI:1073725164
Name:GUACANEME, ANGEL ORLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:ORLANDO
Last Name:GUACANEME
Suffix:
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 1:2000 NW 87TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2656
Mailing Address - Country:US
Mailing Address - Phone:844-665-4827
Mailing Address - Fax:866-523-6595
Practice Address - Street 1:2000 NW 87TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:866-523-6595
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41358208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics