Individual
KARINA FUENTES-GUILLEMYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
807 CHILDRENS WAY, NEMOURS CHILDRENS CLINIC, JACKSONVILLE, FL 32207
(904) 697-3694
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
230416
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279675900
—
FL
Enumeration date
12/13/2006
Last updated
09/25/2022
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