Healthcare Provider Details

I. General information

NPI: 1811891195
Provider Name (Legal Business Name): GUERLANDA CIVIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6424 18TH AVE FL 2
BROOKLYN NY
11204-3729
US

IV. Provider business mailing address

16222 SW 18TH ST
MIRAMAR FL
33027-4456
US

V. Phone/Fax

Practice location:
  • Phone: 212-687-7464
  • Fax:
Mailing address:
  • Phone: 754-248-7594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberN06391-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: