| Organization Name: | RAPHAEL F. GUANZON, M.D., PLLC |
| NPI Number: | 1871897058 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAPHAEL FAJARDO GUANZON (OWNER) |
| Mailing Address: | 704 London St Suite A Portsmouth |
| State: | VA US |
| Postal Code: | 237042413 |
| Phone Number: | 7573990513 |
| Fax Number: | 7574650785 |
| NPI Enumeration Date: | 01/03/2011 |
| NPI Last Update Date: | 01/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101026720 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |