Provider Demographics
NPI:1821178658
Name:KERNISANT, GUYLENE LACOMBE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:GUYLENE
Middle Name:LACOMBE
Last Name:KERNISANT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-500-2009
Mailing Address - Fax:305-500-2145
Practice Address - Street 1:11000 SW 211 STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189
Practice Address - Country:US
Practice Address - Phone:305-254-1500
Practice Address - Fax:305-254-1518
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1950172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21714Medicare ID - Type Unspecified