NPI |
1568932150 |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Entity Type Code |
1 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Last Name Legal Name |
GUARINO CAMGEMI |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider First Name |
VICENTE |
The first name of the provider, if the provider
is an individual. |
Provider Middle Name |
JOSE |
The first name of the provider, if the provider
is an individual. |
Provider Credential Text |
SA-C |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider First Line Business Practice Location Address |
12921 ENTRADA DR |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address City Name |
ORLANDO |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
FL |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
328374617 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The other abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider Business Practice Location Address Telephone Number |
4074374858 |
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional
name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other. |
Provider Enumeration Date |
11/27/2018 |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Last Update Date |
11/27/2018 |
The city name in the location address of the provider being identified. |
Provider Gender Code |
M |
The State code in the location of the provider
being identified. |
Healthcare Provider Taxonomy Code 1 |
246ZC0007X |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider License Number 1 |
18-493 |
The country code in the location address of the provider being identified. |
Provider License Number State Code 1 |
TX |
The telephone number associated with the location address of the provider being identified. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
The fax number associated with the location
address of the provider being identified. |
Is Sole Proprietor |
Y |
The date the provider was assigned a unique identifier (assigned an NPI). |