Provider Demographics
NPI:1942525605
Name:BUITRAGO GUEVARA, IVAN ANDRES (MD)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:ANDRES
Last Name:BUITRAGO GUEVARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8950 N KENDALL DR
Mailing Address - Street 2:SUITE 601
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2144
Mailing Address - Country:US
Mailing Address - Phone:305-279-4500
Mailing Address - Fax:305-598-1741
Practice Address - Street 1:8950 N KENDALL DR
Practice Address - Street 2:SUITE 601
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2144
Practice Address - Country:US
Practice Address - Phone:305-279-4500
Practice Address - Fax:305-598-1741
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME119321207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine