Healthcare Provider Details

I. General information

NPI: 1457795809
Provider Name (Legal Business Name): LISA GUGLIELMO-PEZONE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2013
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5162 LINTON BLVD STE 203
DELRAY BEACH FL
33484-6567
US

IV. Provider business mailing address

4601 NW 26TH AVE
BOCA RATON FL
33434-2557
US

V. Phone/Fax

Practice location:
  • Phone: 561-499-3919
  • Fax: 561-499-4338
Mailing address:
  • Phone: 561-843-5510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP 9194206
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: