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General NPI Number Information
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NPI Number | 1720383060
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Entity Type | Organization
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Legal Business Name | DR CARLOS GUERRA PA
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 5601 N DIXIE HWY #107
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City | OAKLAND PARK
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State | FL
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Zip | 33334-4148
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Country | US
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Telephone | 954-493-9752
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Fax | 954-493-9472
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Provider Business Mailing Address
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Address Line | 5601 N DIXIE HWY #107
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City | OAKLAND PARK
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State | FL
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Zip | 33334-4148
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Country | US
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Telephone | 954-493-9752
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Fax | 954-493-9472
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Authorized Official
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Title or Position | OWNER
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Name | CARLOS O GUERRA
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Credential | M.D.
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Telephone | 954-232-9539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME 103544
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License Number State | FL
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