Provider Demographics
NPI:1154919603
Name:ACOSTA GUZMAN, JUAN (APRN)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:ACOSTA GUZMAN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7175 SW 8TH ST STE 201-202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4676
Mailing Address - Country:US
Mailing Address - Phone:786-234-7253
Mailing Address - Fax:
Practice Address - Street 1:7175 SW 8TH ST STE 201-202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4676
Practice Address - Country:US
Practice Address - Phone:786-234-7253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010299363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner