Provider Demographics
NPI:1255960472
Name:GUILFORD, DANITZCA
Entity type:Individual
Prefix:
First Name:DANITZCA
Middle Name:
Last Name:GUILFORD
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 1:1606 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-3753
Mailing Address - Country:US
Mailing Address - Phone:850-381-6334
Mailing Address - Fax:
Practice Address - Street 1:1606 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-3753
Practice Address - Country:US
Practice Address - Phone:850-381-6334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker