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NPI Code Detail

MEDICARE: ANTHONY NMN GUARISCO JR. BSW

MEDICARE:   ANTHONY NMN GUARISCO JR. BSW
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
1104100000XSocial Worker

Other Identifiers

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

General Provider Information

NPI Number : 1629101035
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY NMN GUARISCO JR. BSW
Provider Business Mailing Address
First Line : 871 W OAKLAND PARK BLVD
Second Line : SUITE 300
City : WILTON MANORS
State : FL
Zip : 33311-1731
Country : US
Telephone Number : 954-567-7141
Fax Number : 954-703-2029
Provider Business Practice Location Address
First Line : 871 W OAKLAND PARK BLVD
Second Line : SUITE 300
City : WILTON MANORS
State : FL
Zip : 33311-1731
Country : US
Telephone Number : 954-567-7141
Fax Number : 954-703-2029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 09/27/2010

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