Organization
VALDOSTA ALLERGY, ASTHMA, & IMMUNOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN C GUARDERAS MD (OWNER)
(229) 247-1667
Entity
Organization
Contact information
Practice address
3334 GREYSTONE WAY, VALDOSTA, GA 31605-1096
(229) 247-1667
(229) 245-7661
Mailing address
PO BOX 3068, VALDOSTA, GA 31604-3068
(229) 247-1667
(229) 245-7661
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207KA0200X
Allergy Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000892966F
—
GA
Enumeration date
07/27/2022
Last updated
08/11/2022
Update your record
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