Individual provider Active NPI

Anthony NMN Guarisco Jr., BSW

  • Social Worker
  • Wilton Manors, FL
National Provider Identifier
1629101035
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
871 W Oakland Park Blvd
Suite 300
Wilton Manors, FL 33311-1731
Phone
(954) 567-7141
Fax
(954) 703-2029
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

871 W Oakland Park Blvd
Suite 300
Wilton Manors, FL 33311-1731

Mailing address

871 W Oakland Park Blvd
Suite 300
Wilton Manors, FL 33311-1731
Phone (954) 567-7141

Other identifiers 1

IdentifierTypeStateIssuer
679083600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1629101035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 W OAKLAND PARK BLVD",
            "address_2": "SUITE 300",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333111731",
            "telephone_number": "954-567-7141",
            "fax_number": "954-703-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 W OAKLAND PARK BLVD",
            "address_2": "SUITE 300",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333111731",
            "telephone_number": "954-567-7141",
            "fax_number": "954-703-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARISCO",
        "first_name": "ANTHONY",
        "middle_name": "NMN",
        "name_suffix": "Jr.",
        "credential": "BSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679083600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.