MEDICARE: DR. BETZAIDA E GUERRA PHD

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	101YM0800X	Mental Health Counselor	MH10525	FL

General Provider Information

NPI Number	:	1720592199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETZAIDA E GUERRA PHD

Provider Business Mailing Address
First Line	:	7100 SW 99TH AVE STE 203
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4668
Country	:	US
Telephone Number	:	305-810-9823
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 SW 99TH AVE STE 203
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4668
Country	:	US
Telephone Number	:	305-810-9823
Fax Number	:

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

Provider Enumeration Date	:	11/21/2017
Last Update Date	:	11/21/2017

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