Provider Demographics
NPI:1811324585
Name:GUELDE, ELIZABETH BLAINE (APRN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:BLAINE
Last Name:GUELDE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 533632
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32853-3632
Mailing Address - Country:US
Mailing Address - Phone:689-233-9653
Mailing Address - Fax:689-220-0576
Practice Address - Street 1:1617 MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5508
Practice Address - Country:US
Practice Address - Phone:689-233-9653
Practice Address - Fax:689-220-0576
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005551363LA2100X, 363LP0808X
MDR217320363LA2100X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty