Provider Demographics
NPI:1912415639
Name:GUIRADO, ORLANDO R SR (MA)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:R
Last Name:GUIRADO
Suffix:SR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14322 NE 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1402
Mailing Address - Country:US
Mailing Address - Phone:786-239-6931
Mailing Address - Fax:786-999-8234
Practice Address - Street 1:14322 NE 18TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1402
Practice Address - Country:US
Practice Address - Phone:786-239-6931
Practice Address - Fax:786-999-8234
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL71157225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016466000Medicaid