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General NPI Number Information
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NPI Number | 1780513697
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Entity Type | Organization
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Legal Business Name | CARDIOMETABOLIC PRIMARY CARE, LLC
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Dates
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Enumeration Date | 05/16/2026
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Last Update Date | 05/16/2026
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Provider Practice Location Address
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Address Line | 15407 IBIS FALL PL
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-6782
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Country | US
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Telephone | 239-692-1157
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 6TH AVE W STE 100
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City | BRADENTON
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State | FL
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Zip | 34205-7413
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GUEDRY EDOUARD
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Credential | NP
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Telephone | 239-692-1157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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