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Individual provider Active NPI

Ivan A Guerrero, MD

  • Infectious Disease Physician
  • Jacksonville, FL
National Provider Identifier
1326016536
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME82361 Issued in FL
Practice address
6817 Southpoint Pkwy Ste 802
Jacksonville, FL 32216
Phone
(904) 646-1987
Fax
(904) 646-1501
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME82361 FL Primary

Addresses

Primary practice location

6817 Southpoint Pkwy Ste 802
Jacksonville, FL 32216

Mailing address

P.O. Box 551272
Jacksonville, FL 32255-1272
Phone (904) 646-1987

Other practice location 1

11555 Central Pkwy
Suite 204
Jacksonville, FL 32224-2691
Phone (904) 646-1987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000367 FL Practitioner - Infectious DiseasePractitioner - Internal Medicine 5193778942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivan Guerrero MD PAGroup PAC ID 1153402466, 2 clinicians

Practice addresses (Care Compare)

6817 Southpoint Pkwy
Suite 802
Jacksonville, FL 32216-6292
Phone (904) 646-1987

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME82361FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivan Guerrero MD PA CurrentSince Dec 15, 2007 Accepting new patients
Florida Department of Health Past Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 802
Jacksonville, FL 32216
Phone (904) 422-8038

11555 Central Pkwy
Ste 204
Jacksonville, FL 32224
Phone (904) 646-1987

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1326016536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 551272",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551272",
            "telephone_number": "904-646-1987",
            "fax_number": "904-646-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 802",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-646-1987",
            "fax_number": "904-646-1501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11555 Central Pkwy",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322242691",
            "country_code": "US",
            "telephone_number": "904-646-1987",
            "fax_number": "904-646-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "IVAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME82361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.