Provider Demographics
NPI:1013687904
Name:SULBARAN, GUADALUPE (APRN)
Entity type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:SULBARAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 FOREST HILL BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6055
Mailing Address - Country:US
Mailing Address - Phone:619-641-1815
Mailing Address - Fax:561-964-1196
Practice Address - Street 1:1840 FOREST HILL BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6055
Practice Address - Country:US
Practice Address - Phone:561-964-1181
Practice Address - Fax:561-964-1196
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015333363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner