Healthcare Provider Details
I. General information
NPI: 1255802997
Provider Name (Legal Business Name): YOHELI M GUTIERREZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/06/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7950 NW 53RD ST STE 102
DORAL FL
33166-4681
US
IV. Provider business mailing address
7950 NW 53RD ST STE 102
DORAL FL
33166-4681
US
V. Phone/Fax
- Phone: 786-631-3222
- Fax: 786-245-4721
- Phone: 786-631-3222
- Fax: 786-245-4721
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 9428408 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: