Provider Demographics
NPI:1548621113
Name:ISSASI, GUADALUPE (ARNP-FNP-C)
Entity type:Individual
Prefix:MRS
First Name:GUADALUPE
Middle Name:
Last Name:ISSASI
Suffix:
Gender:F
Credentials:ARNP-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 US 301 S
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-5806
Mailing Address - Country:US
Mailing Address - Phone:813-374-8883
Mailing Address - Fax:
Practice Address - Street 1:10420 US 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5806
Practice Address - Country:US
Practice Address - Phone:813-374-8883
Practice Address - Fax:813-443-8361
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9177415363LF0000X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health