Provider Demographics
NPI:1174516140
Name:DEGUIA, DANTON N (MD)
Entity type:Individual
Prefix:DR
First Name:DANTON
Middle Name:N
Last Name:DEGUIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 85001
Mailing Address - Street 2:SEPT #0528
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0528
Mailing Address - Country:US
Mailing Address - Phone:941-584-0043
Mailing Address - Fax:941-496-8627
Practice Address - Street 1:1287 US 41 BYPASS S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2900
Practice Address - Country:US
Practice Address - Phone:941-584-0043
Practice Address - Fax:941-496-8627
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34341207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79459Medicare PIN
FLD58796Medicare UPIN