| Doctor Name: | EDUARDO GUARISMA |
| NPI Number: | 1003230756 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | A.R.N.P. |
| License Number: | 2748972 |
| Business Practice Address: | 228 W Alexander St Plant City, FL - 335637157 |
| Business Phone Number: | 8137545480 |
| Business Fax Number: | 8137542251 |
| Mailing Address: | Po Box 616788, ORLANDO |
| State: | FL |
| Postal Code: | 328166788 |
| Phone Number: | 4072533535 |
| Fax Number: | |
| NPI Enumeration Date: | 02/14/2014 |
| NPI Last Update Date: | 09/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2748972 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |