Provider Demographics
NPI:1073976445
Name:GUERRERO GORMAN, VICTORIA EUGENIA (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:EUGENIA
Last Name:GUERRERO GORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 NW 12TH AVE # 4070
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-243-4960
Mailing Address - Fax:305-243-3634
Practice Address - Street 1:1611 NW 12TH AVE # 4070
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-4960
Practice Address - Fax:305-243-3634
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME157642207V00000X, 207V00000X
NJ25MA10872900207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology