Guatevida LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GUATEVIDA LLC

Practice address

14330 Midway Rd Ste 229
Dallas, TX 75244-3514

Phone

(214) 377-8144

Fax

(214) 414-2533

NPI assigned

Oct 6, 2014

Organization subpart

No

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

Authorized official

Name

John Riley

Title

Owner

Phone

(214) 695-4942

Specialties & licenses 2

Addresses

Other names 1

• Dermitech Phototherapy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1053714915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801403",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753801403",
            "telephone_number": "214-377-8144",
            "fax_number": "214-414-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14330 MIDWAY RD STE 229",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443514",
            "telephone_number": "214-377-8144",
            "fax_number": "214-414-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUATEVIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-695-4942"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermitech Phototherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Guardian Health Systems Medical Park
• Guardian Home Health Care
• Guillermo Guardiola Jr., CRNA
• Kristen Kelly Guarisco, CRNA
• Stevan Guarneri
• Susan Carol Guba, MD
• Dwayne Anthony Guccione
• Geethanjali Gude, MD
• Kunhee Gudger, RN
• Paul Arthur Gudmundsson

• Durable Medical Equipment & Medical Supplies in Dallas, TX
• Providers in Dallas, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.