Provider Demographics
NPI:1578301065
Name:GUZMAN, GABRIELA MARIE (HIS)
Entity type:Individual
Prefix:MISS
First Name:GABRIELA
Middle Name:MARIE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3632
Mailing Address - Country:US
Mailing Address - Phone:305-551-7222
Mailing Address - Fax:305-551-7220
Practice Address - Street 1:2261 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3508
Practice Address - Country:US
Practice Address - Phone:305-250-5608
Practice Address - Fax:305-250-5611
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5823237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty