Provider Demographics
NPI:1194579169
Name:GUIRGUIS, FADY (APRN)
Entity type:Individual
Prefix:
First Name:FADY
Middle Name:
Last Name:GUIRGUIS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2236 GREEN HEDGES WAY
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-8189
Mailing Address - Country:US
Mailing Address - Phone:813-999-0505
Mailing Address - Fax:813-701-9450
Practice Address - Street 1:2236 GREEN HEDGES WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-8189
Practice Address - Country:US
Practice Address - Phone:813-999-0505
Practice Address - Fax:813-701-9450
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031934363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner