Provider Demographics
NPI:1033268172
Name:GUERRERO, JENNY C (OT)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:C
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 SW 135TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3340
Mailing Address - Country:US
Mailing Address - Phone:305-279-8157
Mailing Address - Fax:305-279-8158
Practice Address - Street 1:9380 SW 72ND ST
Practice Address - Street 2:SUITE B-222
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3276
Practice Address - Country:US
Practice Address - Phone:305-279-8157
Practice Address - Fax:305-279-8158
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist