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General NPI Number Information
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NPI Number | 1124007331
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Entity Type | Individual
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Provider Name | JANICE GUALTIERE CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 5540 LINTON BLVD SUITE 258
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City | DELRAY BLEACH
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State | FL
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Zip | 33484-6514
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Country | US
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Telephone | 561-498-4440
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Fax | 954-938-0957
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Provider Business Mailing Address
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Address Line | PO BOX 551420
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City | FORT LAUDERDALE
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State | FL
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Zip | 33355-1420
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Country | US
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Telephone | 800-243-3839
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Fax | 954-839-2569
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ARNP1642052
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP1642052
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License Number State | FL
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