Provider Demographics
NPI:1669467924
Name:PASARIN, GUILLERMO A (MD)
Entity Type:Individual
Prefix:MR
First Name:GUILLERMO
Middle Name:A
Last Name:PASARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 N PINE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6637
Mailing Address - Country:US
Mailing Address - Phone:954-653-3722
Mailing Address - Fax:954-653-3728
Practice Address - Street 1:3540 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6637
Practice Address - Country:US
Practice Address - Phone:954-653-3722
Practice Address - Fax:954-653-3728
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0059295207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372659200Medicaid
P00009097OtherRAILROAD MEDICARE
FL372659200Medicaid
P00009097OtherRAILROAD MEDICARE
5406170001Medicare Oscar/Certification