Provider Demographics
NPI:1932158177
Name:ROSAS-GUYON, PATRICIA M (DPM)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:ROSAS-GUYON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 SW 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-3411
Mailing Address - Country:US
Mailing Address - Phone:305-521-8755
Mailing Address - Fax:305-854-8581
Practice Address - Street 1:631 SW 23RD RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1929
Practice Address - Country:US
Practice Address - Phone:305-854-2222
Practice Address - Fax:305-854-8581
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2583213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390346001Medicaid
FL65494OtherBCBSFL
FL390346001Medicaid
FLU64318Medicare UPIN