Provider Demographics
NPI:1982704128
Name:GUERIN, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:GUERIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:842 SUNSET LAKE BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-7552
Mailing Address - Country:US
Mailing Address - Phone:941-484-3404
Mailing Address - Fax:941-496-7895
Practice Address - Street 1:842 SUNSET LAKE BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7552
Practice Address - Country:US
Practice Address - Phone:941-484-3404
Practice Address - Fax:941-496-7895
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDME78002207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2175307OtherDR GUERIN AETNA #
FL46419OtherDR GUERIN BC/BS#
FL219802OtherDR GUERIN AMERA GROUP#
FL219802OtherDR GUERIN AMERA GROUP#
FL46419OtherDR GUERIN BC/BS#
FL1024450001Medicare NSC
FL2175307OtherDR GUERIN AETNA #