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General NPI Number Information
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NPI Number | 1457795809
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Entity Type | Individual
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Provider Name | LISA GUGLIELMO-PEZONE ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/28/2013
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Last Update Date | 04/28/2013
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Provider Practice Location Address
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Address Line | 1590 NW 10TH AVE SUITE 404
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City | BOCA RATON
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State | FL
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Zip | 33486-1313
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Country | US
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Telephone | 561-391-5800
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Fax | 561-338-9251
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Provider Business Mailing Address
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Address Line | 4601 NW 26TH AVE
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City | BOCA RATON
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State | FL
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Zip | 33434-2557
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Country | US
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Telephone | 561-843-5510
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ARNP 9194206
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License Number State | FL
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