Basic Information
Provider Information
NPI: 1700868007
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUIER
FirstName: CHRISTIAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11945 SAN JOSE BLVD
Address2: STE 300
City: JACKSONVILLE
State: FL
PostalCode: 322231627
CountryCode: US
TelephoneNumber: 9043961725
FaxNumber: 9043964893
Practice Location
Address1: 7051 SOUTHPOINT PKWY S STE 300
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322168713
CountryCode: US
TelephoneNumber: 9043982720
FaxNumber: 9043986408
Other Information
ProviderEnumerationDate: 11/14/2005
LastUpdateDate: 05/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XOPC3008FLY Eye and Vision Services ProvidersOptometrist 

ID Information
IDTypeStateIssuerDescription
NV59101FLMEDICAREOTHER
Q0008644901FLRAILROAD MEDICAREOTHER


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