Provider Demographics
NPI:1942297841
Name:GUZMAN, FELIX EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:EDUARDO
Last Name:GUZMAN
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 1:12600 SW 120TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-9066
Mailing Address - Country:US
Mailing Address - Phone:305-253-0233
Mailing Address - Fax:305-253-6012
Practice Address - Street 1:12600 SW 120TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-9066
Practice Address - Country:US
Practice Address - Phone:305-253-0233
Practice Address - Fax:305-253-6012
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074609207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254586100Medicaid
FL42601Medicare ID - Type Unspecified
FL254586100Medicaid