Provider Demographics
NPI:1922703933
Name:GUERRA-OLIVEIRA, KEVIN S
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:S
Last Name:GUERRA-OLIVEIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12605 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-4420
Mailing Address - Country:US
Mailing Address - Phone:800-716-7917
Mailing Address - Fax:
Practice Address - Street 1:2000 BANKS RD STE 223
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7771
Practice Address - Country:US
Practice Address - Phone:800-716-7917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies