Provider Demographics
NPI:1326645441
Name:UZ SANTOS, GUILLERMO FRANCISCO
Entity Type:Individual
Prefix:MR
First Name:GUILLERMO
Middle Name:FRANCISCO
Last Name:UZ SANTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 NW 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4637
Mailing Address - Country:US
Mailing Address - Phone:786-344-6676
Mailing Address - Fax:
Practice Address - Street 1:281 NW 61ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4637
Practice Address - Country:US
Practice Address - Phone:786-344-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-134955106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician