Provider Demographics
NPI:1346361680
Name:WEBER-GUZMAN, FABIOLA CRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:CRISTINA
Last Name:WEBER-GUZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FABIOLA
Other - Middle Name:CRISTINA
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:13535 NEMOURS PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7402
Practice Address - Country:US
Practice Address - Phone:407-567-4000
Practice Address - Fax:407-567-5924
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARTP 001914208000000X
FLME1168492085P0229X
DEC100105402085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics