Provider Demographics
NPI:1598247132
Name:GUIDISH, NICOLE JULIANNE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:JULIANNE
Last Name:GUIDISH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 E THATCH PALM CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7165
Mailing Address - Country:US
Mailing Address - Phone:239-776-2635
Mailing Address - Fax:
Practice Address - Street 1:6330 W INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7981
Practice Address - Country:US
Practice Address - Phone:561-741-1220
Practice Address - Fax:561-741-1230
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS581891835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist