# ORLY GUERON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508295916
- **Authorized official:** ORLY GUERON (DIRECTOR)
- **Authorized official phone:** (305) 924-6555

## Contact information

- **Practice address:** 2875 NE 191ST ST, SUITE 538, AVENTURA, FL 33180-2801
- **Practice address phone:** (305) 924-6555
- **Practice address fax:** (305) 924-6555
- **Mailing address:** 2875 NE 191ST ST, SUITE 538, AVENTURA, FL 33180-2801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | MT 2306 | FL | Yes |

## Other

- **Enumeration date:** 11/06/2013
- **Last updated:** 11/06/2013