Provider Demographics
NPI:1790082246
Name:GUZEVICIENE, RASA
Entity Type:Individual
Prefix:
First Name:RASA
Middle Name:
Last Name:GUZEVICIENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RASA
Other - Middle Name:
Other - Last Name:GUZEVICIENE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:20814 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1147
Mailing Address - Country:US
Mailing Address - Phone:305-933-8433
Mailing Address - Fax:305-933-9115
Practice Address - Street 1:20814 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1147
Practice Address - Country:US
Practice Address - Phone:305-933-8433
Practice Address - Fax:305-933-9115
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9105717363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant