Doctor Name: | DR. JUANA MARIA GUTIERREZ |
NPI Number: | 1114925427 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | ME84846 |
Business Practice Address: | 321 Opa Locka Blvd Opa Locka, FL - 330543526 |
Business Phone Number: | 7864763333 |
Business Fax Number: | 7864763334 |
Mailing Address: | 321 Opa Locka Blvd, OPA LOCKA |
State: | FL |
Postal Code: | 330543526 |
Phone Number: | 7864763333 |
Fax Number: | 7864763334 |
NPI Enumeration Date: | 07/11/2005 |
NPI Last Update Date: | 04/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME84846 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |