Provider Demographics
NPI:1093257875
Name:GUERRERO, LOISA (MSW)
Entity Type:Individual
Prefix:
First Name:LOISA
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10404 W FLAGLER STREET
Mailing Address - Street 2:SUITE 15
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174
Mailing Address - Country:US
Mailing Address - Phone:786-558-8509
Mailing Address - Fax:786-536-9517
Practice Address - Street 1:10404 W FLAGLER ST
Practice Address - Street 2:SUITE 15
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1615
Practice Address - Country:US
Practice Address - Phone:786-558-8509
Practice Address - Fax:786-536-9517
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FL1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool