Active NPI
Maribeth Guerrero
- Assisted Living Facility
- Riverview, FL
National Provider Identifier
1902645914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 12625
- Practice address
- 12413 Riverglen Dr
Riverview, FL 33569-8213 - Phone
- (813) 892-5970
- NPI assigned
- May 20, 2024
- Last updated
- May 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 12625 | FL | Primary |
Addresses
Primary practice location
12413 Riverglen Dr
Riverview, FL 33569-8213
Mailing address
3778 Reflection Dock Dr
Seffner, FL 33584-5217
Phone (813) 892-5970
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12625 | FL | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1902645914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3778 REFLECTION DOCK DR",
"city": "SEFFNER",
"state": "FL",
"postal_code": "335845217",
"telephone_number": "813-892-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12413 RIVERGLEN DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335698213",
"telephone_number": "813-892-5970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRERO",
"first_name": "MARIBETH",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "12625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.