MEDICARE: GUERLINE VEILLARD APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11004585	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95016404	CA

General Provider Information

NPI Number	:	1275179558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUERLINE VEILLARD APRN

Provider Business Mailing Address
First Line	:	6005 NW 68TH TER
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-5676
Country	:	US
Telephone Number	:	954-825-5796
Fax Number	:

Provider Business Practice Location Address
First Line	:	6005 NW 68TH TER
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-5676
Country	:	US
Telephone Number	:	954-825-5796
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	06/10/2026

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