Provider Demographics
NPI:1447878137
Name:GUZMAN, GABRIEL JOSE
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:JOSE
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 1:9037 SW 23RD LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2062
Mailing Address - Country:US
Mailing Address - Phone:305-742-5962
Mailing Address - Fax:
Practice Address - Street 1:9037 SW 23RD LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2062
Practice Address - Country:US
Practice Address - Phone:305-742-5962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer