Provider Demographics
NPI:1164156105
Name:GUERRERO, MARIA P
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:P
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 SW 114TH TER APT 3107
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7755
Mailing Address - Country:US
Mailing Address - Phone:786-301-9672
Mailing Address - Fax:
Practice Address - Street 1:2850 SW 114TH TER APT 3107
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-7755
Practice Address - Country:US
Practice Address - Phone:786-301-9672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT22-224702106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician