Healthcare Provider Details

I. General information

NPI: 1003496258
Provider Name (Legal Business Name): AMBER GUTIERREZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER GORDON

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 112727
GAINESVILLE FL
32611-2727
US

IV. Provider business mailing address

PO BOX 112727
GAINESVILLE FL
32611-2727
US

V. Phone/Fax

Practice location:
  • Phone: 508-521-4873
  • Fax:
Mailing address:
  • Phone: 508-521-4873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberOS23869
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: