| Raphael F. Guanzon, M.d., Pllc | |
|
704 London St Suite A Portsmouth VA 23704-2413 | |
| (757) 399-0513 | |
| (757) 465-0785 |
| Full Name | Raphael F. Guanzon, M.d., Pllc |
|---|---|
| Speciality | General Practice |
| Location | 704 London St, Portsmouth, Virginia |
| Authorized Official Name and Position | Raphael Fajardo Guanzon (OWNER) |
| Authorized Official Contact | 7573990513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raphael F. Guanzon, M.d., Pllc 704 London St Suite A Portsmouth VA 23704-2413 Ph: (757) 399-0513 | Raphael F. Guanzon, M.d., Pllc 704 London St Suite A Portsmouth VA 23704-2413 Ph: (757) 399-0513 |
| NPI Number | 1871897058 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 01/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871897058 | NPI | - | NPPES |
| 003121 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0101026720 (Virginia) | Primary |
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