Ivan Guerrero MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME82361 Issued in FL

Legal business name

IVAN GUERRERO MD PA

Practice address

6817 Southpoint Pkwy
Suite 502
Jacksonville, FL 32216-6282

Phone

(904) 646-3017

Fax

(904) 646-1501

NPI assigned

Oct 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ivan A Guerrero, M.D.NPI 1326016536

Title

President

Phone

(904) 646-1987

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ivan A Guerrero, MD

  • Infectious Disease Physician
  • Jacksonville, FL
  • NPI 1326016536
  Medicare reassignment Care Compare group NPD Authorized official
• Yesenia Baez

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
  • NPI 1770724726
  Medicare reassignment Care Compare group NPD
• Jennifer McNeal, APRN

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1326671371
  Medicare reassignment
• Dima Nassour Nassour, MD

  • Infectious Disease Physician
  • Jacksonville, FL
  • NPI 1245425065
  NPD
• Jose P Vindas Cordero, MD

  • Infectious Disease Physician
  • Wellington, FL
  • NPI 1326050105

  Specialist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1053508184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551272",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551272",
            "telephone_number": "904-646-3017",
            "fax_number": "904-646-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY",
            "address_2": "SUITE 502",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166282",
            "telephone_number": "904-646-3017",
            "fax_number": "904-646-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN GUERRERO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "GUERRERO",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-646-1987",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME82361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000802800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krishna Israni, M.D.
• Niemat Issa
• Rommy Issa, M.D.
• Amihan Noelle Culi Iszler, DPT
• Its Holistic Therapy LLC
• Alina Ivaniuk, MD
• Jacqueline Ivey
• Karon Irene Ivey, LMHC
• Petronia D Ivey
• Walter Warren Ivey III, AU.D

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.