Healthcare Provider Details

I. General information

NPI: 1750011268
Provider Name (Legal Business Name): ENRICO GUARINO RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 AUDREY RD
BELMONT MA
02478-3870
US

IV. Provider business mailing address

42 AUDREY RD
BELMONT MA
02478-3870
US

V. Phone/Fax

Practice location:
  • Phone: 786-717-9900
  • Fax:
Mailing address:
  • Phone: 786-717-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number20-298
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN2365408
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: