Healthcare Provider Details

I. General information

NPI: 1083938708
Provider Name (Legal Business Name): LUIS ENRIQUE GUTIERREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 NW 41ST ST
DORAL FL
33166-6202
US

IV. Provider business mailing address

8600 NW 41ST ST STE 406
DORAL FL
33166-6202
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-5366
  • Fax: 305-644-6407
Mailing address:
  • Phone: 305-642-5366
  • Fax: 305-644-6407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME108014
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: