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General NPI Number Information
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NPI Number | 1437922861
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Entity Type | Individual
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Provider Name | SERGIO GARCIA-GUTIERREZ LMT
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Gender | Male
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 6175 NW 153RD ST STE 204
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2435
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Country | US
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Telephone | 786-536-7280
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Fax | 888-412-1788
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Provider Business Mailing Address
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Address Line | 3055 W 16TH AVE APT 509
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City | HIALEAH
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State | FL
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Zip | 33012-4567
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Country | US
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Telephone | 929-300-6000
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA101704
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License Number State | FL
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