Provider Demographics
NPI:1831203975
Name:GUERRA, LISBETH (PT)
Entity type:Individual
Prefix:
First Name:LISBETH
Middle Name:
Last Name:GUERRA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16751 NW 89TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6318
Mailing Address - Country:US
Mailing Address - Phone:305-364-1890
Mailing Address - Fax:305-364-9840
Practice Address - Street 1:16751 NW 89TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-6318
Practice Address - Country:US
Practice Address - Phone:305-364-1890
Practice Address - Fax:305-364-9840
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20503225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3210AMedicare ID - Type Unspecified