MEDICARE: MICHAEL M GUTIERREZ M.D.

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	207N00000X	Dermatology Physician	ME50355	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03731	OTHER	FL	BCBS OF FL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881630119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL M GUTIERREZ M.D.

Provider Business Mailing Address
First Line	:	7652 ASHLEY PARK CT
Second Line	:	SUITE 305
City	:	ORLANDO
State	:	FL
Zip	:	32835
Country	:	US
Telephone Number	:	407-299-7333
Fax Number	:	407-293-2049

Provider Business Practice Location Address
First Line	:	7652 ASHLEY PARK CT
Second Line	:	SUITE 305
City	:	ORLANDO
State	:	FL
Zip	:	32835
Country	:	US
Telephone Number	:	407-299-7333
Fax Number	:	407-293-2049

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/31/2023

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