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General NPI Number Information
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NPI Number | 1194978932
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Entity Type | Individual
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Provider Name | JUAN CARLOS GUTIERREZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 1720 SE 16TH AVE STE 303
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City | OCALA
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State | FL
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Zip | 34471-4620
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Country | US
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Telephone | 352-368-1661
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Fax | 352-867-9497
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Provider Business Mailing Address
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Address Line | 1720 SE 16TH AVE STE 303
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City | OCALA
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State | FL
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Zip | 34471-4620
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Country | US
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Telephone | 352-368-1661
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Fax | 352-867-9497
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME111240
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License Number State | FL
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