Basic Information
| Provider Information | |||||||||
| NPI: | 1568946861 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUINART GUTIERREZ | ||||||||
| FirstName: | DENIA | ||||||||
| MiddleName: | VICTORIA | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 CAMINO DE VIDA STE 300 | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | NM | ||||||||
| PostalCode: | 884352267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5754724311 | ||||||||
| FaxNumber: | 5754724313 | ||||||||
| Practice Location | |||||||||
| Address1: | 680 N UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330246738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552266633 | ||||||||
| FaxNumber: | 8662857068 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2018 | ||||||||
| LastUpdateDate: | 08/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 9402310 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | 363LF0000X | CNP-57126 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 9402310 | 01 | FL | ADVANCED REGISTERED NURSE PRACTITIONER | OTHER |