Provider Demographics
NPI:1154044006
Name:GUITEAU, SANDRA MICHELLE (NP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MICHELLE
Last Name:GUITEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:MICHELLE
Other - Last Name:APONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2681 N FLAMINGO RD APT 2705S
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1778
Mailing Address - Country:US
Mailing Address - Phone:954-557-0057
Mailing Address - Fax:
Practice Address - Street 1:2681 N FLAMINGO RD APT 2705S
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-1778
Practice Address - Country:US
Practice Address - Phone:954-557-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2022060370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily