MEDICARE: DOREY ARDERI 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	171M00000X	Case Manager/Care Coordinator		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	:	1528622099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOREY ARDERI GUERRA

Provider Business Mailing Address
First Line	:	13543 SW 59TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-5117
Country	:	US
Telephone Number	:	305-319-9365
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 E 9TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4650
Country	:	US
Telephone Number	:	305-381-5294
Fax Number	:	786-685-2266

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

Provider Enumeration Date	:	04/30/2019
Last Update Date	:	09/17/2024

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