Provider Demographics
NPI:1669421418
Name:GUIRGUIS, AMIR F (MD)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:F
Last Name:GUIRGUIS
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 1:410 CELEBRATION PL STE 103
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5432
Mailing Address - Country:US
Mailing Address - Phone:407-303-4655
Mailing Address - Fax:407-303-4654
Practice Address - Street 1:410 CELEBRATION PL STE 103
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5432
Practice Address - Country:US
Practice Address - Phone:407-303-4655
Practice Address - Fax:407-303-4654
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104423207R00000X
OH35074402207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002850700Medicaid
OH2089967Medicaid
FL14A5DOtherBCBS
OHP00705939OtherRAILROAD CARE
FL14A5DOtherBCBS
FL002850700Medicaid
OHP00705939OtherRAILROAD CARE
OH4012893Medicare PIN