Juan M Gutierrez Md Pa | |
11880 Sw 40th St Suite 404 Miami FL 33175-3584 | |
(305) 227-6618 | |
(305) 227-6668 |
Full Name | Juan M Gutierrez Md Pa |
---|---|
Speciality | Clinic/Center |
Location | 11880 Sw 40th St, Miami, Florida |
Authorized Official Name and Position | Juan M Gutierrez (PHYSICIAN) |
Authorized Official Contact | 3052276618 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Juan M Gutierrez Md Pa 11880 Sw 40th St Suite 404 Miami FL 33175-3584 Ph: (305) 227-6618 | Juan M Gutierrez Md Pa 11880 Sw 40th St Suite 404 Miami FL 33175-3584 Ph: (305) 227-6618 |
NPI Number | 1417363185 |
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Provider Enumeration Date | 07/02/2014 |
Last Update Date | 08/06/2015 |
Medicare PECOS PAC ID | 2668786716 |
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Medicare Enrollment ID | O20150803000913 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417363185 | NPI | - | NPPES |
068939400 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | ME40749 (Florida) | Primary |
Provider Name | Juan M Gutierrez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619079084 PECOS PAC ID: 0941357867 Enrollment ID: I20090413000117 |
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