Guzman Rodriguez, Tamara Ivelisse
Guzman Rodriguez, Tamara Ivelisse is an sole proprietor health care provider with primary practice located at 130 Ridge Center Dr , Davenport FL 33837-6413. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Guzman Rodriguez, Tamara Ivelisse can be contacted via phone (866) 234-8534.Contact Information
Primary practice address
130 Ridge Center Dr
Davenport FL 33837-6413
Phone: (866) 234-8534
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 15632 | Puerto Rico |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ACN 448 | Florida |
Profile Details
| NPI number | 1063443612 |
|---|---|
| LBN Legal business name | Guzman Rodriguez, Tamara Ivelisse |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063443612 | NPPES |
| Florida | MEDICAID | 1063443612 | |
| Florida | Other | ACN 448 |
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