Organization
IVAN GUERRERO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN A GUERRERO M.D. (PRESIDENT)
(904) 646-1987
Entity
Organization
Contact information
Practice address
6817 SOUTHPOINT PKWY, SUITE 502, JACKSONVILLE, FL 32216-6282
(904) 646-3017
(904) 646-1501
Mailing address
PO BOX 551272, JACKSONVILLE, FL 32255-1272
(904) 646-3017
(904) 646-1501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME82361
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000802800
—
FL
Enumeration date
10/03/2007
Last updated
05/21/2015
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