Provider Demographics
NPI:1184007932
Name:GUEVARA, ANAELY (DMD)
Entity Type:Individual
Prefix:
First Name:ANAELY
Middle Name:
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 SW 3RD ST APT 8
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1825
Mailing Address - Country:US
Mailing Address - Phone:305-766-4886
Mailing Address - Fax:
Practice Address - Street 1:2030 SW 3RD ST APT 8
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1825
Practice Address - Country:US
Practice Address - Phone:305-766-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21384122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist