Provider Demographics
NPI:1174512065
Name:GUERRIER, FREDERIC JUDES (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:JUDES
Last Name:GUERRIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FREDERIC
Other - Middle Name:JUDES
Other - Last Name:GUERRIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:500 10TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-5214
Mailing Address - Country:US
Mailing Address - Phone:727-898-4461
Mailing Address - Fax:727-502-0841
Practice Address - Street 1:500 10TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-5214
Practice Address - Country:US
Practice Address - Phone:727-898-4461
Practice Address - Fax:727-502-0841
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040544207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068581000Medicaid
FL62392YMedicare PIN
FLE16932Medicare UPIN