Provider Demographics
NPI:1467581082
Name:C N GUERRIERE MD PA
Entity Type:Organization
Organization Name:C N GUERRIERE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CILIO
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:GUERRIERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-960-4484
Mailing Address - Street 1:14502 N DALE MABRY HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2075
Mailing Address - Country:US
Mailing Address - Phone:813-960-4484
Mailing Address - Fax:813-265-1522
Practice Address - Street 1:14502 N DALE MABRY HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2100
Practice Address - Country:US
Practice Address - Phone:813-960-4484
Practice Address - Fax:813-265-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME14463208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007138800Medicaid
FLD26840Medicare UPIN
FL71490Medicare ID - Type Unspecified