Healthcare Provider Details

I. General information

NPI: 1164997680
Provider Name (Legal Business Name): ON-SITE MEDICAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37534 HIGHWAY 30 STE A
GONZALES LA
70737-8098
US

IV. Provider business mailing address

37534 HIGHWAY 30 STE A
GONZALES LA
70737-8098
US

V. Phone/Fax

Practice location:
  • Phone: 225-217-4344
  • Fax: 225-224-3523
Mailing address:
  • Phone: 225-644-6767
  • Fax: 225-644-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANK FLOYD GUARISCO JR.
Title or Position: COO
Credential: APRN, NP-C
Phone: 225-644-6767