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NPI Code Detail

MEDICARE: PABLO GUERRERO PT

MEDICARE: PABLO GUERRERO PT
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
1225100000XPhysical TherapistPT38056FL
2225100000XPhysical Therapist11155RLA
3225100000XPhysical TherapistLPT-32645AZ

General Provider Information

NPI Number : 1376269860
Entity Type Code : Individual
Provider Name (Legal Business Name) : PABLO GUERRERO PT
Provider Business Mailing Address
First Line : PO BOX 649
Second Line :
City : FORT DEFIANCE
State : AZ
Zip : 86504-0649
Country : US
Telephone Number : 928-729-8000
Fax Number :
Provider Business Practice Location Address
First Line : CORNER OF ROUTE N12 AND N7
Second Line :
City : FORT DEFIANCE
State : AZ
Zip : 86504
Country : US
Telephone Number : 928-729-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2022
Last Update Date : 03/10/2026

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