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NPI Code Detail

MEDICARE: MICHELLE GUTIERREZ

MEDICARE: MICHELLE GUTIERREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1235553298
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE GUTIERREZ
Provider Business Mailing Address
First Line : 3316 MASTERCRAFT AVE
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89031-7239
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6889 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4687
Country : US
Telephone Number : 702-434-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2014
Last Update Date : 02/12/2014

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Directions to “ MICHELLE GUTIERREZ ” Practice Location

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