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General NPI Number Information
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NPI Number | 1184983322
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Entity Type | Individual
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Provider Name | JASON NICHOLAS GUERRERO DPT, CEAS, CSCS
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Gender | Male
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 10570 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33174-2612
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Country | US
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Telephone | 305-222-1982
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Fax |
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Provider Business Mailing Address
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Address Line | 16224 SW 79TH TER
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City | MIAMI
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State | FL
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Zip | 33193-3429
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Country | US
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Telephone | 786-390-9586
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT25087
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License Number State | FL
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