Provider Demographics
NPI:1053596114
Name:GUZMAN, MELVIN (MS)
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16256 OLD ASH LOOP
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-6906
Mailing Address - Country:US
Mailing Address - Phone:407-928-2877
Mailing Address - Fax:
Practice Address - Street 1:2300 LEE RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1750
Practice Address - Country:US
Practice Address - Phone:407-339-7451
Practice Address - Fax:407-862-2737
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health