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General NPI Number Information
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NPI Number | 1225631195
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Entity Type | Individual
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Provider Name | JOSE ANTONIO GUTIERREZ PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 3105 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-4201
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Country | US
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Telephone | 305-649-9364
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Fax | 305-642-1409
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Provider Business Mailing Address
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Address Line | 3800 SW 102ND AVE APT 220
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City | MIAMI
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State | FL
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Zip | 33165-4502
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Country | US
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Telephone | 786-325-8959
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS56905
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License Number State | FL
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