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JUAN CARLOS CARDET GUISASAOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
247405
MA
207K00000X
Allergy & Immunology Physician
Primary
ME133105
FL
207R00000X
Internal Medicine Physician
12022R
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022650100
FL
01
IFANC
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/22/2008
Last updated
03/30/2021
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