Healthcare Provider Details

I. General information

NPI: 1093515967
Provider Name (Legal Business Name): BARBARA GUERRERO ASIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 NW SAINT LUCIE WEST BLVD
PORT ST LUCIE FL
34986-1963
US

IV. Provider business mailing address

2831 STONEWAY LN
FORT PIERCE FL
34982-4347
US

V. Phone/Fax

Practice location:
  • Phone: 772-237-1731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-413977
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: