Provider Demographics
NPI:1699773341
Name:GUARNERI, RALPH (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:GUARNERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2502
Mailing Address - Country:US
Mailing Address - Phone:954-462-8714
Mailing Address - Fax:954-462-8722
Practice Address - Street 1:1508 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2502
Practice Address - Country:US
Practice Address - Phone:954-462-8714
Practice Address - Fax:954-462-8722
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60839208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12937OtherBLUE CROSS BLUE SHIELD
FL99250OtherVYTRA HEALTHCARE
FL2202500OtherAETNA
FL650747893OtherHUMANA
FL650747893OtherTRICARE
FL24727OtherHEALTHEASE
FL612221200OtherFLORIDA DEPT OF LABOR
FL650747893 0003OtherCIGNA
FL057543700Medicaid
FL100820OtherAVMED
FL24020AOtherCAREPLUS
FL24727OtherWELLCARE
FL24727OtherSTAYWELL
FL650747893OtherVISTA
FL24727OtherWELLCARE