Provider Demographics
NPI:1992925929
Name:DWIN, GUILHERME WILLIAM (LDO)
Entity type:Individual
Prefix:
First Name:GUILHERME
Middle Name:WILLIAM
Last Name:DWIN
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4111
Mailing Address - Country:US
Mailing Address - Phone:954-472-2422
Mailing Address - Fax:954-476-2023
Practice Address - Street 1:1767 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4111
Practice Address - Country:US
Practice Address - Phone:954-472-2422
Practice Address - Fax:954-476-2023
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1171156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0663450001Medicare NSC