Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME67142 | FL |
NPI | 1003875261 |
---|---|
Provider Name | Georges C. Guerrier |
First Address | Port St Lucie, FL 34986-2136 |
Second Address | Port St Lucie, FL 34986-2136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 26/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31627 | BCBS PROVIDER # (01) | FL |
379850000 | (05) | FL |
F47232 | (02) | FL |