Provider Demographics
NPI:1336148972
Name:GUBBINS, GUILLERMO P (MD)
Entity Type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:P
Last Name:GUBBINS
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 1:5000 UNIVERSITY DR
Mailing Address - Street 2:SUITE 3370
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2008
Mailing Address - Country:US
Mailing Address - Phone:305-662-6170
Mailing Address - Fax:305-662-6176
Practice Address - Street 1:5000 UNIVERSITY DR
Practice Address - Street 2:SUITE 3370
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:305-662-6170
Practice Address - Fax:305-662-6176
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-16
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0065439207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375047700Medicaid
FL375047700Medicaid
FL25134Medicare ID - Type Unspecified