Healthcare Provider Details

I. General information

NPI: 1538009816
Provider Name (Legal Business Name): MRS. GIAVONNI BEATRICE PEGUERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 STEPHENSON AVE STE 101
SAVANNAH GA
31405-5899
US

IV. Provider business mailing address

7382 SAN ISIDRO RD APT A
FORT STEWART GA
31315-1272
US

V. Phone/Fax

Practice location:
  • Phone: 912-358-0231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2025039553
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: