Provider Demographics
NPI:1053336933
Name:GUIOT, BERNARD H (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:H
Last Name:GUIOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3123
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32085-3123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14810 OLD SAINT AUGUSTINE RD STE 207
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2558
Practice Address - Country:US
Practice Address - Phone:904-217-7450
Practice Address - Fax:904-217-7483
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME79764207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO73434256Medicaid
CO98524241Medicaid
COC477738Medicare PIN
COCO304510Medicare PIN