Basic Information
| Provider Information | |||||||||
| NPI: | 1407859093 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUZMAN | ||||||||
| FirstName: | NORMA | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3155 CITRUS TOWER BLVD | ||||||||
| Address2: | |||||||||
| City: | CLERMONT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347116803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525574965 | ||||||||
| FaxNumber: | 3522420053 | ||||||||
| Practice Location | |||||||||
| Address1: | 3155 CITRUS TOWER BLVD | ||||||||
| Address2: | |||||||||
| City: | CLERMONT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347116803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522421500 | ||||||||
| FaxNumber: | 3522420053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2005 | ||||||||
| LastUpdateDate: | 08/01/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME 88192 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 267687700 | 05 | FL | MEDICAID |