Healthcare Provider Details

I. General information

NPI: 1316530710
Provider Name (Legal Business Name): MARIA PAULA GUTIERREZ LOPEZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 SUMMER COVE DR
RIVERVIEW FL
33578-8953
US

IV. Provider business mailing address

1312 APOLLO BEACH BLVD STE C
APOLLO BEACH FL
33572-3037
US

V. Phone/Fax

Practice location:
  • Phone: 813-317-0620
  • Fax:
Mailing address:
  • Phone: 813-922-5644
  • Fax: 813-322-2014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27246
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: