Provider Demographics
NPI:1356644264
Name:GUEVARA, DENISE M (DO)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 N. UNIVERSITY DRIVE
Mailing Address - Street 2:S. 307
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321
Mailing Address - Country:US
Mailing Address - Phone:954-720-7272
Mailing Address - Fax:954-720-1878
Practice Address - Street 1:7421 N. UNIVERSITY DRIVE
Practice Address - Street 2:S. 307
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321
Practice Address - Country:US
Practice Address - Phone:954-720-7272
Practice Address - Fax:954-720-1878
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS10856207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology