Provider Demographics
NPI:1467129452
Name:GUARDIAN HEALTH LLC
Entity Type:Organization
Organization Name:GUARDIAN HEALTH LLC
Other - Org Name:GUARDIAN HEALTH LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHAPSHARE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-305-5713
Mailing Address - Street 1:300 TAMIAMI TRL S UNIT 1
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2422
Mailing Address - Country:US
Mailing Address - Phone:941-303-5713
Mailing Address - Fax:941-786-3914
Practice Address - Street 1:300 TAMIAMI TRL S UNIT 1
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2422
Practice Address - Country:US
Practice Address - Phone:941-303-5713
Practice Address - Fax:941-786-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty