Individual
DR. GUSTAVO MARTIN HUAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1475 W 49TH PL, HIALEAH, FL 33012-3113
(305) 558-2500
Mailing address
12565 NW 57TH CT, CORAL SPRINGS, FL 33076-3469
(954) 393-8759
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
32599
FL
363AS0400X
Surgical Physician Assistant
PA9106514
FL
Other
Enumeration date
06/27/2012
Last updated
05/05/2021
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