| Miguel A Gutierrez-diaz, D.o., Pllc | |
|
4700 Bayou Blvd Ste 2c Pensacola FL 32503-2670 | |
| (850) 501-3935 | |
| Not Available |
| Full Name | Miguel A Gutierrez-diaz, D.o., Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4700 Bayou Blvd Ste 2c, Pensacola, Florida |
| Authorized Official Name and Position | Eddy Gutierrez-diaz (OFFICE MANAGER) |
| Authorized Official Contact | 8505013935 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miguel A Gutierrez-diaz, D.o., Pllc 4700 Bayou Blvd Ste 2c Pensacola FL 32503-2670 Ph: (850) 501-3935 | Miguel A Gutierrez-diaz, D.o., Pllc 4700 Bayou Blvd Ste 2c Pensacola FL 32503-2670 Ph: (850) 501-3935 |
| NPI Number | 1114542867 |
|---|---|
| Provider Enumeration Date | 06/09/2020 |
| Last Update Date | 06/09/2020 |
| Medicare PECOS PAC ID | 7517387053 |
|---|---|
| Medicare Enrollment ID | O20201021002433 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114542867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Miguel A Gutierrez-diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194777912 PECOS PAC ID: 4284790064 Enrollment ID: I20090303000192 |
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