Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME135035 | FL |
N | 111NI0900X | Internist | ME135035 | FL |
N | 207RH0000X | Hematologist | ME135035 | FL |
Y | 207RX0202X | Medical Oncology | ME135035 | FL |
NPI | 1124155569 |
---|---|
Provider Name | Elizabeth A. Guancial |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Sarasota, FL 34236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 11/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
024572800 | (05) | FL |