Provider Demographics
NPI:1881566503
Name:GUZMAN REYNA, VICTOR LUIS
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:LUIS
Last Name:GUZMAN REYNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 W 68TH ST APT 417
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5133
Mailing Address - Country:US
Mailing Address - Phone:305-407-7717
Mailing Address - Fax:
Practice Address - Street 1:1075 W 68TH ST APT 417
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5133
Practice Address - Country:US
Practice Address - Phone:305-407-7717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty