MEDICARE: DR. CARL P GUARINO MD

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	207Y00000X	Otolaryngology Physician	203277	NY
2	207Y00000X	Otolaryngology Physician	01088921A	IN
3	2085R0202X	Diagnostic Radiology Physician	203277	NY
4	2085R0202X	Diagnostic Radiology Physician	01088921A	IN
5	2085R0202X	Diagnostic Radiology Physician	ME149374	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588656698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL P GUARINO MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16511 BERWICK TER
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34202-5292
Country	:	US
Telephone Number	:	315-415-3450
Fax Number	:

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	11/20/2023

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Directions to “ DR. CARL P GUARINO MD” Practice Location

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