Provider Demographics
NPI:1366846032
Name:ANTOINE, GUEMPS IV
Entity Type:Individual
Prefix:
First Name:GUEMPS
Middle Name:
Last Name:ANTOINE
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4007 11TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33976-2830
Mailing Address - Country:US
Mailing Address - Phone:239-895-4047
Mailing Address - Fax:
Practice Address - Street 1:4007 11TH ST SW
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33976-2830
Practice Address - Country:US
Practice Address - Phone:239-895-4047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide