Provider Demographics
NPI:1881318376
Name:DR. MCGUIRE, NP LLC
Entity type:Organization
Organization Name:DR. MCGUIRE, NP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/NP
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMEKO
Authorized Official - Middle Name:HAZLEY
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:850-226-8096
Mailing Address - Street 1:124 E MIRACLE STRIP PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1990
Mailing Address - Country:US
Mailing Address - Phone:850-226-8096
Mailing Address - Fax:
Practice Address - Street 1:124 E MIRACLE STRIP PKWY STE 202
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1990
Practice Address - Country:US
Practice Address - Phone:850-226-8096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty