Provider Demographics
NPI:1114711454
Name:GUERRERO, KIARA J
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:J
Last Name:GUERRERO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ASHFORD DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-9100
Mailing Address - Country:US
Mailing Address - Phone:347-651-9403
Mailing Address - Fax:
Practice Address - Street 1:3357 W VINE ST STE 103
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4664
Practice Address - Country:US
Practice Address - Phone:407-201-6255
Practice Address - Fax:407-201-7195
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician