Provider Demographics
NPI:1164051546
Name:GUHA, SHOWRAB (PA-C)
Entity Type:Individual
Prefix:
First Name:SHOWRAB
Middle Name:
Last Name:GUHA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21097 NE 27TH CT STE 320
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1206
Mailing Address - Country:US
Mailing Address - Phone:305-937-3022
Mailing Address - Fax:305-937-3023
Practice Address - Street 1:21097 NE 27TH CT STE 320
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1206
Practice Address - Country:US
Practice Address - Phone:305-937-3022
Practice Address - Fax:305-937-3023
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113485363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty