Provider Demographics
NPI:1689785297
Name:GUYTON, MARCELA (LM)
Entity Type:Individual
Prefix:MRS
First Name:MARCELA
Middle Name:
Last Name:GUYTON
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9760 SW 13 TERRACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2915
Mailing Address - Country:US
Mailing Address - Phone:305-220-1772
Mailing Address - Fax:305-456-3897
Practice Address - Street 1:3850 SW 87TH AVE
Practice Address - Street 2:SUITE #102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5400
Practice Address - Country:US
Practice Address - Phone:305-220-1772
Practice Address - Fax:305-225-0220
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW90175M00000X
FLLM90176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340034400Medicaid
FLLM90OtherLICENSED MIDWIFE