Provider Demographics
NPI:1396549531
Name:GUERRERO MORA, JUNIOR
Entity type:Individual
Prefix:
First Name:JUNIOR
Middle Name:
Last Name:GUERRERO MORA
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 1:158 SE 37TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-6216
Mailing Address - Country:US
Mailing Address - Phone:929-471-2205
Mailing Address - Fax:
Practice Address - Street 1:158 SE 37TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-6216
Practice Address - Country:US
Practice Address - Phone:929-471-2205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician