Provider Demographics
NPI:1801818232
Name:GUERRA, OSCAR R (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:R
Last Name:GUERRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 145028
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-5028
Mailing Address - Country:US
Mailing Address - Phone:305-446-9658
Mailing Address - Fax:305-446-8258
Practice Address - Street 1:836 PONCE DE LEON BLVD
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3039
Practice Address - Country:US
Practice Address - Phone:305-446-9658
Practice Address - Fax:305-446-8258
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056615207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064530300Medicaid
FLE65250Medicare UPIN
FL064530300Medicaid
FLK1286Medicare ID - Type UnspecifiedMEDICARE GROUP ID