MEDICARE: LUIS E GUERRERO, MD, PC

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
1	207RP1001X	Pulmonary Disease Physician	166025	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	166025	OTHER		LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205010931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUIS E GUERRERO, MD, PC

Provider Business Mailing Address
First Line	:	1216 BEACH AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-4755
Country	:	US
Telephone Number	:	718-597-1107
Fax Number	:	718-597-8567

Provider Business Practice Location Address
First Line	:	1216 BEACH AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-4755
Country	:	US
Telephone Number	:	718-597-1107
Fax Number	:	718-597-8567

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUIS E GUERRERO
Credential	:	MD
Telephone Number	:	718-299-2100

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	03/07/2023

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