Provider Demographics
NPI:1255371761
Name:GUERREIRO, SERGIO M
Entity type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:M
Last Name:GUERREIRO
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 1:8100 SW 10TH ST BLDG 3
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3279
Mailing Address - Country:US
Mailing Address - Phone:954-210-1031
Mailing Address - Fax:
Practice Address - Street 1:8100 SW 10TH ST BLDG 3
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3279
Practice Address - Country:US
Practice Address - Phone:954-210-1031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1086231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4899807OtherGHI
FL40007057OtherPEDIATRIC ASSOCIATES
FL600332000Medicaid
FLS2275ZMedicare PIN