Provider Demographics
NPI:1467969212
Name:MCGUFFIN, ELIZABETH DORIS
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DORIS
Last Name:MCGUFFIN
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 1:5790 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5634
Mailing Address - Country:US
Mailing Address - Phone:754-210-3900
Mailing Address - Fax:
Practice Address - Street 1:5790 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5634
Practice Address - Country:US
Practice Address - Phone:754-210-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies