Healthcare Provider Details

I. General information

NPI: 1861345605
Provider Name (Legal Business Name): DR. NELSON JOSE FINOL GUTIERREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 GULF TO BAY BLVD
CLEARWATER FL
33759-4514
US

IV. Provider business mailing address

17621 ESPRIT DR
TAMPA FL
33647-2506
US

V. Phone/Fax

Practice location:
  • Phone: 813-730-9340
  • Fax:
Mailing address:
  • Phone: 813-730-9340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH31154
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDTP883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: