Individual
DR. MARY JEAN S. DEGUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
895 SW 30TH AVE, SUITE 101, POMPANO BEACH, FL 33069-4887
(954) 633-3387
(954) 633-3217
Mailing address
12596 NW 67TH DR, PARKLAND, FL 33076-1961
(954) 340-7041
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
ME70419
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME70419
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220019667
RR MEDICARE
FL
05
—
252471200
—
FL
Enumeration date
12/13/2005
Last updated
06/17/2013
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