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General NPI Number Information
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NPI Number | 1124476817
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Entity Type | Organization
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Legal Business Name | JOSE GUERRA MD & ASSOCIATES LLC
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 6001 SW 70TH ST APT 347
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City | SOUTH MIAMI
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State | FL
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Zip | 33143
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Country | US
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Telephone | 786-514-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 SW 70TH ST APT 347
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3426
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Country | US
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Telephone | 786-514-2450
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOSE ARMANDO GUERRA-VALENCIA
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Credential | MD
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Telephone | 786-514-2450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME121917
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | ME121917
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | ME121917
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License Number State | FL
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