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General NPI Number Information
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NPI Number | 1437377702
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Entity Type | Organization
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Legal Business Name | CHILDRENS GASTROENTEROLOGY OF SOUTH FLORIDA
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 12959 PALMS WEST DRIVE SUITE 210
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City | LOXAHATCHEE
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State | FL
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Zip | 33470
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Country | US
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Telephone | 561-795-3333
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Fax | 561-791-3002
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Provider Business Mailing Address
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Address Line | 12959 PALMS WEST DRIVE SUITE 210
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City | LOXAHATCHEE
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State | FL
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Zip | 33470
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Country | US
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Telephone | 561-795-3333
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Fax | 561-791-3002
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | ROBERTO A GUERRERO
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Credential | MD
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Telephone | 561-601-1599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME71612
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License Number State | FL
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