Provider Demographics
NPI:1174512958
Name:GUITIAN, JOSE ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:GUITIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BAPTIST WAY STE 3A
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2274
Mailing Address - Country:US
Mailing Address - Phone:448-227-6500
Mailing Address - Fax:448-227-6500
Practice Address - Street 1:125 BAPTIST WAY STE 3A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2274
Practice Address - Country:US
Practice Address - Phone:448-227-6500
Practice Address - Fax:448-227-6500
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51809207RC0000X, 207RI0011X
LAMD08477R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL59244760OtherBCBS AL
FL114520700Medicaid
FL18788OtherBCBS
ALA18854AOtherMEDICARE
AL009962430Medicaid
FLNT413OtherMEDICARE
060065399OtherRAILROAD MEDICARE
2500240OtherUNITED HEALTHCARE
FL18788OtherBCBS