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Individual

SAMIR C GURU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1945 BAY RD, MOUNT DORA, FL 32757-2105
(352) 483-5633
(352) 483-5070
Mailing address
1945 BAY RD, MOUNT DORA, FL 32757-2105
(352) 483-5633
(352) 483-5070

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OS9328
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16714
BLUE CROSS BLUE SHIELD FL
FL
01
DD9204
RAILROAD MEDICARE GROUP
FL
01
P00260225
RAILROAD MEDICARE GURU
FL
Enumeration date
09/23/2005
Last updated
05/04/2017
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