Provider Demographics
NPI:1053659144
Name:GUILMEUS, FIADAH
Entity Type:Individual
Prefix:
First Name:FIADAH
Middle Name:
Last Name:GUILMEUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FIADAH
Other - Middle Name:
Other - Last Name:GUILMEUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5042 ASHLEY LAKE DR APT 422
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3165
Mailing Address - Country:US
Mailing Address - Phone:954-297-5368
Mailing Address - Fax:
Practice Address - Street 1:5042 ASHLEY LAKE DR APT 422
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3165
Practice Address - Country:US
Practice Address - Phone:954-297-5368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information