Provider Demographics
NPI:1477534568
Name:GUZMAN, MARTHA ISABEL (RPH)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ISABEL
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14829 CORAL BERRY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2353
Mailing Address - Country:US
Mailing Address - Phone:813-629-8822
Mailing Address - Fax:813-354-3417
Practice Address - Street 1:8000 N ARMENIA AVE
Practice Address - Street 2:SUITE G
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-2758
Practice Address - Country:US
Practice Address - Phone:813-629-8822
Practice Address - Fax:813-354-3417
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist