MEDICARE: MARIELENA GUERRA M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME117309	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1437583416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIELENA GUERRA M.D.

Provider Business Mailing Address
First Line	:	265 COMMERCIAL BLVD
Second Line	:
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-4442
Country	:	US
Telephone Number	:	954-772-3960
Fax Number	:	855-494-7111

Provider Business Practice Location Address
First Line	:	265 COMMERCIAL BLVD
Second Line	:
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-4442
Country	:	US
Telephone Number	:	954-772-3960
Fax Number	:	855-494-7111

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

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	04/13/2020

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