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General NPI Number Information
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NPI Number | 1710545538
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Entity Type | Individual
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Provider Name | MARCELO HECTOR GUERRA
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Gender | Male
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 4560 SW 128TH AVE
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City | MIAMI
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State | FL
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Zip | 33175-4610
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Country | US
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Telephone | 786-973-7474
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Fax |
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Provider Business Mailing Address
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Address Line | 11791 SW 15TH ST
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City | MIAMI
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State | FL
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Zip | 33184-2557
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Country | US
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Telephone | 305-331-1885
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-88826
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-68922
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License Number State |
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