GUILLERMO A PENA MD PA
Osteopathic Medicine in Hialeah, FL

License number
Florida ME 46222
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: GUILLERMO A PENA MD
Title: OWNER
Phone: (305) 363-4666
Address
Address
1435 Pl Suite #403, Hialeah, FL 33012
National Provider ID: 1841480381
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Guillermo A. Pena, M.D., PA

Hialeah, FL

Status:
Inactive
Doing business as:
Guillermo Pena
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Oct 3, 2005
Inactive since:
Sep 25, 2009
Phone:
(305) 362-4666 (Phone)
Addresses:
1435 W 49 Pl, Hialeah, FL 33012
14321 Ardoch Pl, Hialeah, FL 33016
State ID:
P05000134945
Business type:
Florida Profit Corporation
Medical Doctor, President, Urologys:
Guillermo A. Pena Director, Owner, inactive,Cari Pena Manager, inactive,Pablo M. Guala Cardiovascular, inactive,...
Agent:
Guillermo Pena,14321 Ardoch Pl, Hialeah, FL 33016 (Physical)
EIN:
20-3897967

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