=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427395680
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHN F GUARINO MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2013
-----------------------------------------------------
Last Update Date | 02/13/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4245 KINGS HWY UNIT A
-----------------------------------------------------
City | PORT CHARLOTTE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33980
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-391-5102
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4245 KINGS HIGHWAY UNIT A
-----------------------------------------------------
City | PORT CHARLOTTE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33980
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-391-5102
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. JOHN F GUARINO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 941-391-5102
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | ME 0068371
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------