Provider Demographics
NPI:1912307265
Name:GUZMAN, LUIS GUILLERMO
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:GUILLERMO
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 S BENEVA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2472
Mailing Address - Country:US
Mailing Address - Phone:941-366-3062
Mailing Address - Fax:941-957-1686
Practice Address - Street 1:943 S BENEVA RD STE 201
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2472
Practice Address - Country:US
Practice Address - Phone:941-366-3062
Practice Address - Fax:941-957-1686
Is Sole Proprietor?:No
Enumeration Date:2014-08-23
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054552207R00000X
FLME137093207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine