MEDICARE: NIURYSEL ARAGON GUERRA

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	171M00000X	Case Manager/Care Coordinator
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1902310840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIURYSEL ARAGON GUERRA

Provider Business Mailing Address
First Line	:	7110 W 3RD AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-8303
Country	:	US
Telephone Number	:	786-641-1948
Fax Number	:

Provider Business Practice Location Address
First Line	:	7110 W 3RD AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-8303
Country	:	US
Telephone Number	:	786-641-1948
Fax Number	:

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

Provider Enumeration Date	:	11/30/2017
Last Update Date	:	04/12/2024

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