Individual provider Active NPI

Gino Cuello Guzman

  • Surgical Assistant
  • Palm Bay, FL
National Provider Identifier
1023905304
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
25-287 Issued in WI
Practice address
915 Sonesta Ave NE
Palm Bay, FL 32905-6339
Phone
(321) 302-0840
NPI assigned
Jun 19, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 25-287 WI Primary

Addresses

Primary practice location

915 Sonesta Ave NE
Palm Bay, FL 32905-6339

Mailing address

915 Sonesta Ave NE
Palm Bay, FL 32905-6339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25-287WIMDSurgical Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1023905304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 SONESTA AVE NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329056339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SONESTA AVE NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329056339",
            "telephone_number": "321-302-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLO GUZMAN",
        "first_name": "GINO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "25-287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.