Provider Demographics
NPI:1578570727
Name:STRAUSS, GUY S (DO)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:S
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 NW HALL OF FAME DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-4833
Mailing Address - Country:US
Mailing Address - Phone:386-719-2540
Mailing Address - Fax:386-752-9073
Practice Address - Street 1:404 NW HALL OF FAME DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4833
Practice Address - Country:US
Practice Address - Phone:386-719-2540
Practice Address - Fax:386-752-9073
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL1019207R00000X, 207RC0200X
FLOS4706207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD60778Medicare UPIN