Active NPI
Larissa Antonia Guerrero, MD
- Obstetrics & Gynecology Physician
- Lake Mary, FL
National Provider Identifier
1952534547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME 121834
- Practice address
- 1071 S Sun Dr
Suite 1043
Lake Mary, FL 32746-2405 - Phone
- (407) 333-1616
- Fax
- (407) 333-1617
- NPI assigned
- Aug 28, 2009
- Last updated
- Jun 29, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | ME 121834 | FL | Primary |
Addresses
Primary practice location
1071 S Sun Dr
Suite 1043
Lake Mary, FL 32746-2405
Mailing address
1071 S Sun Dr
Suite 1043
Lake Mary, FL 32746-2405
Phone (407) 333-1616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 342677 | Medicaid | SC |
Other names 1
- Larissa Antonia Subero Guerrero
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 121834 | FL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Woman Care, LLC | Obstetrics & Gynecology | Past | Accepting new patients |
Interoperability endpoints
- larissa.guerrero.1@2183.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Obstetrics & Gynecology Physician
- Tampa, FL
- NPI 1386823243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435536000000",
"number": "1952534547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1071 S SUN DR",
"address_2": "SUITE 1043",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462405",
"telephone_number": "407-333-1616",
"fax_number": "407-333-1617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1071 S SUN DR",
"address_2": "SUITE 1043",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462405",
"telephone_number": "407-333-1616",
"fax_number": "407-333-1617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRERO",
"first_name": "LARISSA",
"middle_name": "ANTONIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-28",
"last_updated": "2015-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "ME 121834",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "342677",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LARISSA",
"last_name": "SUBERO GUERRERO",
"middle_name": "ANTONIA",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.