MEDICARE: MR. YOERME GUERRA

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1215324215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YOERME GUERRA

Provider Business Mailing Address
First Line	:	11406 N DALE MABRY HWY STE 204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-3879
Country	:	US
Telephone Number	:	813-230-2026
Fax Number	:	813-898-0264

Provider Business Practice Location Address
First Line	:	11406 N DALE MABRY HWY STE 204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-3879
Country	:	US
Telephone Number	:	813-230-2026
Fax Number	:	813-898-0264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2015
Last Update Date	:	06/01/2015

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