MEDICARE: DANIEL E 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
1	101Y00000X	Counselor		HI

General Provider Information

NPI Number	:	1760150742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL E GUTIERREZ

Provider Business Mailing Address
First Line	:	44 AWA ST
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96720-5802
Country	:	US
Telephone Number	:	808-494-8686
Fax Number	:

Provider Business Practice Location Address
First Line	:	44 AWA ST
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96720-5802
Country	:	US
Telephone Number	:	808-494-8686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	09/02/2021

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Directions to “ DANIEL E GUTIERREZ ” Practice Location

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