=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942452628
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARISEL GUTIERREZ DEL ARROYO COLON M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2008
-----------------------------------------------------
Last Update Date | 06/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2320 NORTH BLVD W STE I-3
-----------------------------------------------------
City | DAVENPORT
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33837-8998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-808-1890
-----------------------------------------------------
Fax | 877-569-3013
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6675 WESTWOOD BLVD STE 475
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32821-6027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-845-0330
-----------------------------------------------------
Fax | 888-972-1752
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | ACN737
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 17350
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------