MEDICARE: GRACE DEGUZMAN ZAGUIRRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9231814	FL

General Provider Information

NPI Number	:	1568628220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE DEGUZMAN ZAGUIRRE

Provider Business Mailing Address
First Line	:	1495 FOREST HILL BLVD
Second Line	:	SUITE A
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6073
Country	:	US
Telephone Number	:	561-968-5553
Fax Number	:	561-300-2115

Provider Business Practice Location Address
First Line	:	1495 FOREST HILL BLVD
Second Line	:	SUITE A
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6073
Country	:	US
Telephone Number	:	561-968-5553
Fax Number	:	561-300-2115

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	11/16/2016

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