Provider Demographics
NPI:1447617428
Name:NAZARIO NAZARIO, GUILLERMO JOSE (DC)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:JOSE
Last Name:NAZARIO NAZARIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5058 SAVANNAH RIVER WAY APT 108
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-5083
Mailing Address - Country:US
Mailing Address - Phone:787-598-8601
Mailing Address - Fax:
Practice Address - Street 1:8915 CONROY WINDERMERE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3127
Practice Address - Country:US
Practice Address - Phone:407-909-4788
Practice Address - Fax:407-909-1788
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11762111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation