Provider Demographics
NPI:1942093950
Name:GUILLAUME, BETHANIE
Entity type:Individual
Prefix:MRS
First Name:BETHANIE
Middle Name:
Last Name:GUILLAUME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2953 BICKLEY DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4809
Mailing Address - Country:US
Mailing Address - Phone:347-666-0615
Mailing Address - Fax:407-703-4011
Practice Address - Street 1:2953 BICKLEY DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-4809
Practice Address - Country:US
Practice Address - Phone:347-666-0615
Practice Address - Fax:407-703-4011
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6907135251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health