Provider Demographics
NPI:1750333290
Name:GUERRERO, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2090 SE OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3304
Mailing Address - Country:US
Mailing Address - Phone:772-287-8777
Mailing Address - Fax:772-287-1996
Practice Address - Street 1:2090 SE OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3304
Practice Address - Country:US
Practice Address - Phone:772-287-8777
Practice Address - Fax:772-287-1996
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME80338174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258892700Medicaid
FL258892700Medicaid
H15431Medicare UPIN