Provider Demographics
NPI:1780055889
Name:GUERRERO, MANRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:MANRIQUE
Middle Name:
Last Name:GUERRERO
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 1:21110 BISCAYNE BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1252
Mailing Address - Country:US
Mailing Address - Phone:305-918-7050
Mailing Address - Fax:
Practice Address - Street 1:1707 W CHARLESTON BLVD STE 160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2354
Practice Address - Country:US
Practice Address - Phone:702-671-5150
Practice Address - Fax:702-384-6493
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS178612086S0102X, 2086S0127X, 208600000X
TXS5636208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery