Provider Demographics
NPI:1841510088
Name:GUILLORY, NATRESE
Entity type:Individual
Prefix:
First Name:NATRESE
Middle Name:
Last Name:GUILLORY
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 1:1308 7TH ST WEST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4511
Mailing Address - Country:US
Mailing Address - Phone:941-527-7962
Mailing Address - Fax:941-723-9523
Practice Address - Street 1:1308 7TH ST W
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-4511
Practice Address - Country:US
Practice Address - Phone:941-527-7962
Practice Address - Fax:941-723-9523
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy