MEDICARE: PETRA GUERRERO-PEREZ

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	183700000X	Pharmacy Technician	2501-0103-0358-680	FL

General Provider Information

NPI Number	:	1427169606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETRA GUERRERO-PEREZ

Provider Business Mailing Address
First Line	:	4110 VIRGINIA TER
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2557
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 VIRGINIA TER
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2557
Country	:	US
Telephone Number	:	561-832-2981
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ PETRA GUERRERO-PEREZ ” Practice Location

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