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General NPI Number Information
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NPI Number | 1760648315
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Entity Type | Individual
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Provider Name | GONZALO N. GUTIERREZ BORGES MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 920 N JOHN YOUNG PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34741-4914
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Country | US
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Telephone | 407-956-1920
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Fax | 407-483-5844
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Provider Business Mailing Address
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Address Line | 121 S ORANGE AVE STE 940
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City | ORLANDO
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State | FL
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Zip | 32801-3234
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Country | US
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Telephone | 407-658-9687
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Fax | 407-286-4515
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | SA00390
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ACN1033
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 19712
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License Number State | PR
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