Individual
JASON GUERRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2201 CENTRAL AVE, ST PETERSBURG, FL 33713-8844
(727) 914-0200
Mailing address
739 53RD AVE N, ST PETERSBURG, FL 33703-2835
(727) 430-2832
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA24929
LICENSE NUMBER
FL
Enumeration date
05/13/2020
Last updated
05/13/2020
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