Provider Demographics
NPI:1710121678
Name:GUERRA, SANTA EMILIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SANTA
Middle Name:EMILIA
Last Name:GUERRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SANTA
Other - Middle Name:EMILIA
Other - Last Name:DE OLIVERIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 25487
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2487
Mailing Address - Country:US
Mailing Address - Phone:941-202-5342
Mailing Address - Fax:855-253-4836
Practice Address - Street 1:7915 US HIGHWAY 301 N STE 107
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-3532
Practice Address - Country:US
Practice Address - Phone:941-847-1101
Practice Address - Fax:941-417-2811
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104920363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant