Herson Ivan Guerrero Pena, TCM CASE MANAGER FCB

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1071 Port Malabar Blvd NE Ste 105-106
Palm Bay, FL 32905-5161

Phone

(321) 355-0073

Fax

(321) 821-6860

NPI assigned

Dec 1, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1861907693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4491 ABERDEEN CIR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556654",
            "telephone_number": "321-355-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 PORT MALABAR BLVD NE STE 105-106",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055161",
            "telephone_number": "321-355-0073",
            "fax_number": "321-821-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO PENA",
        "first_name": "HERSON",
        "middle_name": "IVAN",
        "credential": "TCM CASE MANAGER FCB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Patricia Green, LMHC
• Jeffrey Burt Greenbarg, M.D.
• Alexandria Griffin
• Quita Melissa Griffith, PA-C
• Robin Grodecky, M.A, CCC-SLP
• Guiding Light Senior Living 2 Inc.
• Guiding Light Senior Living Inc
• Cheyenne Leigh Gulk
• Nitesh Gupta
• Stephen Paul Guss, M.D.

• Case Manager/Care Coordinator in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.