Provider Demographics
NPI:1477361848
Name:GUERRA, JOAO PEDRO
Entity type:Individual
Prefix:
First Name:JOAO PEDRO
Middle Name:
Last Name:GUERRA
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 1:200 KNUTH RD STE 230
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4637
Mailing Address - Country:US
Mailing Address - Phone:561-529-9612
Mailing Address - Fax:
Practice Address - Street 1:200 KNUTH RD STE 230
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4637
Practice Address - Country:US
Practice Address - Phone:561-529-9612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician