Provider Demographics
NPI:1467253914
Name:GUILLEN, MAX CARLOS
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:CARLOS
Last Name:GUILLEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6860 CASSIA PLACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014
Mailing Address - Country:US
Mailing Address - Phone:305-804-5010
Mailing Address - Fax:
Practice Address - Street 1:HEALTHCARE NETWORK OF SOUTHWEST FLORIDA
Practice Address - Street 2:1454 MADISON AVE
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142
Practice Address - Country:US
Practice Address - Phone:305-804-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program