Provider Demographics
NPI:1740203488
Name:GUERRERO, JORGE A (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:A
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 780125
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0125
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:
Practice Address - Street 1:1000 E BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1930
Practice Address - Country:US
Practice Address - Phone:804-828-2467
Practice Address - Fax:804-828-5481
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101287063207LP3000X, 207L00000X
ARE-14249207LP3000X, 207L00000X
TXL1596207LP3000X, 207L00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152570107Medicaid
TX152570105Medicaid
TX152570108OtherCSHCN
8BX290OtherBCBS OF TX
8L6963Medicare PIN
H19010Medicare UPIN
TX152570108OtherCSHCN
TXTXB154972Medicare UPIN