Individual provider Active NPI

Peter W. Guyon Jr., MD

  • Pediatric Cardiology Physician
  • Hollywood, FL
National Provider Identifier
1205255510
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME153449 Issued in FL
Practice address
1150 N 35TH Ave Ste 490
Hollywood, FL 33021-5423
Phone
(954) 265-3437
Fax
(954) 265-3731
NPI assigned
Apr 15, 2014
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A138673 CA
Pediatric Cardiology Physician 2080P0202X A138673 CA
Pediatric Cardiology Physician 2080P0202X ME153449 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave Ste 490
Hollywood, FL 33021-5423

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other identifiers 1

IdentifierTypeStateIssuer
112750300MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pguyon292762@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211208002567 FL Practitioner - Interventional CardiologyPractitioner - Pediatric Medicine 9436443561 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
138673CAMDMarriage & Family Therapist
A138673CAMDPediatric Cardiology Physician
ME153449FLMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Dec 20, 2021 Accepting new patients
South Broward Hospital District CurrentSince Dec 20, 2021 Accepting new patients
South Broward Hospital District CurrentSince Mar 15, 2023 Accepting new patients
South Broward Hospital District Pediatrics Past Accepting new patients

Locations

1150 N 35th Ave
Ste 490
Hollywood, FL 33021
Phone (954) 265-3437

3501 Johnson St
Fl 1
Hollywood, FL 33021
Phone (954) 265-7750

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

Interoperability endpoints

  • Direct secure messaging: pguyon292762@mhsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1205255510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 490",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215423",
            "telephone_number": "954-265-3437",
            "fax_number": "954-265-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUYON",
        "first_name": "PETER",
        "middle_name": "W.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A138673",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A138673",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME153449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112750300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pguyon292762@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "1150 N 35th Ave Ste 490",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.