Provider Demographics
NPI:1548133051
Name:GUERRERO CHACON, SARAH ELISA
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELISA
Last Name:GUERRERO CHACON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 GLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2206
Mailing Address - Country:US
Mailing Address - Phone:407-961-0355
Mailing Address - Fax:
Practice Address - Street 1:668 GLENVIEW DR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2206
Practice Address - Country:US
Practice Address - Phone:407-961-0355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-476-882106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician