Provider Demographics
NPI:1295174449
Name:GUIRGUIS, MONICA SAMIR (DO)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:SAMIR
Last Name:GUIRGUIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:SAMIR
Other - Last Name:ELMASHAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1135 E STATE ROAD 434 STE 1001
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-2744
Mailing Address - Country:US
Mailing Address - Phone:407-635-3320
Mailing Address - Fax:407-636-7843
Practice Address - Street 1:1135 E STATE ROAD 434 STE 1001
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-2744
Practice Address - Country:US
Practice Address - Phone:407-635-3320
Practice Address - Fax:407-636-7843
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020750208000000X
FLOS14097208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018416400Medicaid