Provider Demographics
NPI:1477277325
Name:CARRASQUILLO, GUISELLE
Entity Type:Individual
Prefix:
First Name:GUISELLE
Middle Name:
Last Name:CARRASQUILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3668 BOSWORTH RD APT 301
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-6012
Mailing Address - Country:US
Mailing Address - Phone:216-526-5545
Mailing Address - Fax:
Practice Address - Street 1:3668 BOSWORTH RD APT 301
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-6012
Practice Address - Country:US
Practice Address - Phone:216-526-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator