Provider Demographics
NPI:1891290938
Name:LUIS ALFREDO GUERRERO MD PLLC
Entity Type:Organization
Organization Name:LUIS ALFREDO GUERRERO MD PLLC
Other - Org Name:DRG PAIN & ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO & MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALFREDO
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-251-2588
Mailing Address - Street 1:8112 CENTRALIA CT STE 101
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3701
Mailing Address - Country:US
Mailing Address - Phone:352-251-2588
Mailing Address - Fax:352-995-2015
Practice Address - Street 1:8112 CENTRALIA CT STE 101
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3701
Practice Address - Country:US
Practice Address - Phone:352-251-2588
Practice Address - Fax:352-995-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1208012081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty