HERSON IVAN GUERRERO PENA (NPI# 1861907693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861907693 |
| Entity Type | Individual |
| Full Name | HERSON IVAN GUERRERO PENA |
| Credential | TCM CASE MANAGER FCB |
| Practice Address |
1071 Port Malabar Blvd Ne Ste 105-106 Palm Bay FL 32905-5161 |
| Mailing Address |
4491 Aberdeen Cir Rockledge FL 32955-6654 |
| Practice Telephone | 3213550073 |
| Practice Fax Number | 3218216860 |
| Mailing Telephone | 3213550073 |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2017-12-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1071 PORT MALABAR BLVD NE STE 105-106 |
| City | PALM BAY |
| State | FL |
| Zip Code | 32905-5161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460928 | Lavell Woodard Jr. | Counselor | 4206 Pinewood Dr Ne, Palm Bay, FL 32905 | 2020-05-29 |
| 1548735699 | Aaron J Milton | Counselor | 1420 Sportsman Lane Ne, Palm Bay, FL 32905 | 2018-10-04 |
| 1871070417 | The Brevard Health Alliance Inc | Clinic/Center | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-26 |
| 1699266361 | Coastal Visioncare LLC | Optometrist | 2186 Harris Ave Ne Ste 1, Palm Bay, FL 32905 | 2018-05-29 |
| 1184173981 | Jean Elyse Gautreaux | Social Worker | 2475 Palm Bay Rd Ne, Suite 130 #4, Palm Bay, FL 32905 | 2016-09-22 |
| 1174901607 | Reginald Shannon Seecharan | Developmental Therapist | 700 James Cir Ne, Palm Bay, FL 32905 | 2015-05-17 |
| 1881091254 | Courtney Taft | Physical Therapy Assistant | 1155 Malabar Road, Suite 1, Palm Bay, FL 32905 | 2014-12-01 |
| 1548513310 | Juda Marie Decara | Counselor | 4690 Lipscomb St Se, Suite 6c, Palm Bay, FL 32905 | 2012-10-18 |
| 1326308313 | Mohammad Idrees Md, P.a. | Internal Medicine | 1454 Belaire Lane N.e., Palm Bay, FL 32905 | 2012-05-23 |
| 1265704548 | Atm Amin Dds LLC | Dentist | 4620 Lipscomb St Ne, Suite 2, Palm Bay, FL 32905 | 2012-02-02 |
| Find all providers in zip 32905 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515529 | Marchalee Amoya Marshall | Case Manager/Care Coordinator | 501 Nackman Rd Nw, Palm Bay, FL 32907-2806 | 2020-07-20 |
| 1770101149 | Amma A Dewberry | Case Manager/Care Coordinator | 443 Albenga Rd Nw, Palm Bay, FL 32907-1827 | 2020-07-11 |
| 1942831961 | Nahir L Nunez | Case Manager/Care Coordinator | 770 Seymour Rd Ne, Palm Bay, FL 32905-5025 | 2020-01-29 |
| 1508418898 | Monique James | Case Manager/Care Coordinator | 1556 Shelter St Nw, Palm Bay, FL 32907-8653 | 2019-07-16 |
| 1821576224 | Jouzelie Philippi-exantus | Case Manager/Care Coordinator | 296 Paquita Cir Sw, Palm Bay, FL 32908-3402 | 2018-07-30 |
| 1740798297 | Brian Carroll Myerss | Case Manager/Care Coordinator | 1797 Pace Dr Nw, Palm Bay, FL 32907-7095 | 2018-01-18 |
| 1679025761 | Clara Seamon | Case Manager/Care Coordinator | 131 Hammock Rd Se, Palm Bay, FL 32909-8844 | 2016-10-25 |
| 1487005237 | Cassandra Wright | Case Manager/Care Coordinator | 2147 Dr Harvey Riley St Ne Apt C, Palm Bay, FL 32905-2602 | 2016-06-23 |
| 1780032920 | Randolph Edward Allen Jr. | Case Manager/Care Coordinator | 2387 Ramsdale Dr Se, Palm Bay, FL 32909-6492 | 2016-05-27 |
| 1851764591 | Ramon Feliciano | Case Manager/Care Coordinator | 120 Andalusia Ave Nw, Palm Bay, FL 32907-2833 | 2015-11-03 |
| Find all providers in PALM BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.