Provider Demographics
NPI:1285433185
Name:GUIRE, BLAIRE ALEXANDRA (MS RD LD)
Entity type:Individual
Prefix:
First Name:BLAIRE
Middle Name:ALEXANDRA
Last Name:GUIRE
Suffix:
Gender:
Credentials:MS RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 NW 54TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6309
Mailing Address - Country:US
Mailing Address - Phone:864-915-8967
Mailing Address - Fax:
Practice Address - Street 1:1523 NW 54TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6309
Practice Address - Country:US
Practice Address - Phone:864-915-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8773133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered