Individual
DR. ELLA MARIE GUASTAVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3217 S ACCESS RD, ENGLEWOOD, FL 34224-8644
(941) 416-2864
(650) 265-4616
Mailing address
7227 TEABERRY ST, ENGLEWOOD, FL 34224-8051
(941) 416-2864
(650) 265-4616
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
222304
NY
208000000X
Pediatrics Physician
Primary
0059964
FL
208000000X
Pediatrics Physician
185936
NY
2080P0006X
Developmental - Behavioral Pediatrics Physician
ME0059964
FL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
ME0059964
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054127300
—
FL
Enumeration date
03/05/2007
Last updated
10/07/2025
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