Provider Demographics
NPI:1669763728
Name:GUANDALINI, GUSTAVO SOARES (MD)
Entity type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:SOARES
Last Name:GUANDALINI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-7355
Mailing Address - Fax:215-349-8444
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-7355
Practice Address - Fax:215-349-8444
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD465463207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology