Provider Demographics
NPI:1114366937
Name:CHRISTINA M DE GUIA, MD PLLC
Entity type:Organization
Organization Name:CHRISTINA M DE GUIA, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD AND ADOLESCENT PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MOSQUITO
Authorized Official - Last Name:DE GUIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-242-1128
Mailing Address - Street 1:269 S OSPREY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-6805
Mailing Address - Country:US
Mailing Address - Phone:941-364-3629
Mailing Address - Fax:941-227-4724
Practice Address - Street 1:269 S OSPREY AVE
Practice Address - Street 2:STE 200
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-6805
Practice Address - Country:US
Practice Address - Phone:434-242-1128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-15
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111114261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
C0231ZMedicare PIN