Basic Information
| Provider Information | |||||||||
| NPI: | 1174568521 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAGUINSIN | ||||||||
| FirstName: | ELSIE | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7548 CUTLASS AVE | ||||||||
| Address2: | |||||||||
| City: | NORTH BAY VILLAGE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331414114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058677706 | ||||||||
| FaxNumber: | 3056931808 | ||||||||
| Practice Location | |||||||||
| Address1: | 16555 NW 25TH AVE | ||||||||
| Address2: | |||||||||
| City: | OPA LOCKA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330546583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7864661732 | ||||||||
| FaxNumber: | 3056931808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1374132 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | E8195Y | 05 | FL | MEDICAID |