Provider Demographics
NPI:1417760067
Name:GUZMAN, RAQUEL TERESA
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:TERESA
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28058 ARROWHEAD CIR
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-4806
Mailing Address - Country:US
Mailing Address - Phone:727-458-7237
Mailing Address - Fax:
Practice Address - Street 1:25325 RAMPART BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33983-6404
Practice Address - Country:US
Practice Address - Phone:941-629-7466
Practice Address - Fax:941-629-9053
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25860225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant