=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669560926
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID SECUNDINO GUERRA M.D., FACOG, MIGS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2006
-----------------------------------------------------
Last Update Date | 08/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 981 37TH PL
-----------------------------------------------------
City | VERO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32960-6541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-257-5785
-----------------------------------------------------
Fax | 772-257-5325
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 827 18TH ST
-----------------------------------------------------
City | VERO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32960-6481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-925-8200
-----------------------------------------------------
Fax | 772-925-8199
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | R9293
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 04-51393
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | ME104419
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------