MEDICARE: DR. FREDDY GUERRERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	17091	FL

General Provider Information

NPI Number	:	1578689360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDDY GUERRERO

Provider Business Mailing Address
First Line	:	14762 SW 56TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4067
Country	:	US
Telephone Number	:	305-382-6662
Fax Number	:

Provider Business Practice Location Address
First Line	:	14762 SW 56TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4067
Country	:	US
Telephone Number	:	305-382-6662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. FREDDY GUERRERO ” Practice Location

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