Provider Demographics
NPI:1376129718
Name:ELIAS, GUIDO J (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:GUIDO
Middle Name:J
Last Name:ELIAS
Suffix:
Gender:M
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15463 SW 148TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4627
Mailing Address - Country:US
Mailing Address - Phone:786-738-1014
Mailing Address - Fax:
Practice Address - Street 1:15463 SW 148TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-4627
Practice Address - Country:US
Practice Address - Phone:786-738-1014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily