MEDICARE: DR. MARC JOEL GUTTMAN DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208800000X	Urology Physician	OS11355	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00956371	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14E5P	OTHER	FL	BCBS FL
2	346329	OTHER	FL	AVMED
3	46196	OTHER	FL	UNIVERSAL HEALTHCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1193091	OTHER	FL	WELLCARE
7	7156430	OTHER	FL	CIGNA
8	9454740	OTHER	FL	AETNA
9	P994084	OTHER	FL	FREEDOM
10	3328120	OTHER	FL	UNITED HEALTHCARE
11	P959369	OTHER	FL	OPTIMUM
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972708154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC JOEL GUTTMAN DO

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: MANAGED CARE DEPT.
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	8625 COLLIER BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3550
Country	:	US
Telephone Number	:	239-434-8565
Fax Number	:	239-434-8569

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	04/20/2016

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