MEDICARE: STEPHANY GUERRERO

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	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1528796158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANY GUERRERO

Provider Business Mailing Address
First Line	:	3282 CANOE CREEK RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-9115
Country	:	US
Telephone Number	:	407-624-5649
Fax Number	:

Provider Business Practice Location Address
First Line	:	3282 CANOE CREEK RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-9115
Country	:	US
Telephone Number	:	407-624-5649
Fax Number	:

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

Provider Enumeration Date	:	08/11/2022
Last Update Date	:	11/28/2022

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Directions to “ STEPHANY GUERRERO ” Practice Location

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