Healthcare Provider Details

I. General information

NPI: 1093257875
Provider Name (Legal Business Name): LOISA GUERRERO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10404 W FLAGLER ST SUITE 15
MIAMI FL
33174-1615
US

IV. Provider business mailing address

10404 W FLAGLER STREET SUITE 15
MIAMI FL
33174
US

V. Phone/Fax

Practice location:
  • Phone: 786-558-8509
  • Fax: 786-536-9517
Mailing address:
  • Phone: 786-558-8509
  • Fax: 786-536-9517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: