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NPI Code Detail

MEDICARE: LUIS GABRIEL GUERRERO PA-C

MEDICARE: LUIS GABRIEL GUERRERO PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1033649454
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS GABRIEL GUERRERO PA-C
Provider Business Mailing Address
First Line : 14508 BELLE VILLA DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-3492
Country : US
Telephone Number : 225-328-3120
Fax Number :
Provider Business Practice Location Address
First Line : 2840 FLORIDA BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70802-2721
Country : US
Telephone Number : 225-224-2402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2017
Last Update Date : 06/18/2017

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Directions to “ LUIS GABRIEL GUERRERO PA-C” Practice Location

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