Provider Demographics
NPI:1669560926
Name:GUERRA, DAVID SECUNDINO (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SECUNDINO
Last Name:GUERRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 US HIGHWAY 27 N
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1691
Mailing Address - Country:US
Mailing Address - Phone:863-471-1236
Mailing Address - Fax:863-304-8157
Practice Address - Street 1:3670 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1691
Practice Address - Country:US
Practice Address - Phone:863-471-1236
Practice Address - Fax:863-304-8157
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR9293207V00000X
FLME104419207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002457800Medicaid
FL002457800Medicaid
FL002457800Medicaid