Provider Demographics
NPI:1861652331
Name:GUANZON, VERNA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:VERNA
Middle Name:LUZ
Last Name:GUANZON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VERNA
Other - Middle Name:LUZ
Other - Last Name:CABIGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:118 OAKWOOD DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-3001
Mailing Address - Country:US
Mailing Address - Phone:434-846-8421
Mailing Address - Fax:434-846-2655
Practice Address - Street 1:118 OAKWOOD DR
Practice Address - Street 2:SUITE A
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-3001
Practice Address - Country:US
Practice Address - Phone:434-846-8421
Practice Address - Fax:434-846-2655
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1861652331Medicaid
VA1861652331Medicaid