Individual provider Active NPI

Marlon Faustino Guerra Tejera, APRN

  • Family Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1740899129
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008283 Issued in FL
Practice address
3351 Executive Way
Miramar, FL 33025-3935
Phone
(954) 628-5361
Fax
(954) 380-8379
NPI assigned
Jul 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11008283 FL Primary

Addresses

Primary practice location

3351 Executive Way
Miramar, FL 33025-3935

Mailing address

13258 SW 29TH St
Miami, FL 33175-7130
Phone (786) 394-3481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201209002461 FL Practitioner - Nurse Practitioner 0345652715 Reassigns benefits to 1 organization
Practice locations: Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kendall South Rehab IncGroup PAC ID 4587083217, 3 clinicians

Practice addresses (Care Compare)

4689 Ponce de Leon Blvd
Suite 200
Coral Gables, FL 33146-2133
Phone (305) 491-9169

Hospital & facility affiliations

  • Caring for Health Home Care, Inc Home health agency, Hialeah, FL, CCN 109251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kendall South Rehab Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

4689 Ponce de Leon Blvd
Ste 200
Coral Gables, FL 33146
Phone (305) 491-9169

Organizations & group practices 1

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

Hospital & facility affiliations 1

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": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1740899129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13258 SW 29TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331757130",
            "telephone_number": "786-394-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EXECUTIVE WAY",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253935",
            "telephone_number": "954-628-5361",
            "fax_number": "954-380-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA TEJERA",
        "first_name": "MARLON",
        "middle_name": "FAUSTINO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.