MEDICARE: DR. PIO I GUERRERO JR. MD

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	208100000X	Physical Medicine & Rehabilitation Physician	42321	CO

General Provider Information

NPI Number	:	1972533909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PIO I GUERRERO JR. MD

Provider Business Mailing Address
First Line	:	2222 N NEVADA AVE
Second Line	:	STE 5020
City	:	COLORADO SPGS
State	:	CO
Zip	:	80907-6868
Country	:	US
Telephone Number	:	719-776-5960
Fax Number	:	719-776-5045

Provider Business Practice Location Address
First Line	:	2222 N NEVADA AVE
Second Line	:	STE 5020
City	:	COLORADO SPGS
State	:	CO
Zip	:	80907-6868
Country	:	US
Telephone Number	:	719-776-5960
Fax Number	:	719-776-5045

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	03/19/2008

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