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General NPI Number Information
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NPI Number | 1982337390
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Entity Type | Individual
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Provider Name | REGLA C GUTIERREZ MORALES APRN
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Gender | Female
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Dates
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Enumeration Date | 07/04/2022
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 9088 PROGRESS BLVD
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City | RIVERVIEW
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State | FL
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Zip | 33578-4886
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Country | US
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Telephone | 813-444-0220
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Fax | 813-367-1961
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Provider Business Mailing Address
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Address Line | 6100 BLUE LAGOON DR STE 365
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City | MIAMI
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State | FL
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Zip | 33126-7010
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Country | US
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Telephone | 786-322-7333
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Fax | 786-347-5022
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11020563
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License Number State | FL
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