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General NPI Number Information
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NPI Number | 1174749691
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Entity Type | Individual
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Provider Name | EDY AUGUSTO GUERRA DDS
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4011 W FLAGLER ST SUITE 506
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City | CORAL GABLES
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State | FL
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Zip | 33134-1643
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Country | US
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Telephone | 305-643-1444
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Fax | 305-643-0447
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Provider Business Mailing Address
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Address Line | 145 DEER RUN
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5787
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Country | US
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Telephone | 305-643-1444
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Fax | 305-643-0447
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN13559
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License Number State | FL
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