Healthcare Provider Details

I. General information

NPI: 1346460532
Provider Name (Legal Business Name): MARIA DEL CARMEN GUTIERREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10621 N KENDALL DR STE 113
MIAMI FL
33176-1549
US

IV. Provider business mailing address

10621 N KENDALL DR STE 113
MIAMI FL
33176-1549
US

V. Phone/Fax

Practice location:
  • Phone: 786-397-2588
  • Fax: 305-670-6007
Mailing address:
  • Phone: 305-670-6006
  • Fax: 305-670-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME100361
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: