Provider Demographics
NPI:1992342703
Name:ZUNIGA VEGA, GUIDO MAURICIO (SA-C)
Entity type:Individual
Prefix:
First Name:GUIDO
Middle Name:MAURICIO
Last Name:ZUNIGA VEGA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 SONOMA DR
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-1883
Mailing Address - Country:US
Mailing Address - Phone:561-537-1994
Mailing Address - Fax:
Practice Address - Street 1:3411 SONOMA DR
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-1883
Practice Address - Country:US
Practice Address - Phone:561-537-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-30
Last Update Date:2019-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-487246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty