Provider Demographics
NPI:1245790989
Name:MAGGI DE LA GUARDIA, LOURDES (MD)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:
Last Name:MAGGI DE LA GUARDIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9964 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1802
Mailing Address - Country:US
Mailing Address - Phone:407-261-2900
Mailing Address - Fax:321-203-4654
Practice Address - Street 1:9964 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1802
Practice Address - Country:US
Practice Address - Phone:407-261-2900
Practice Address - Fax:321-203-4654
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME153515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine