MEDICARE: HEIDI GUTHMILLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-21-49376	FL

General Provider Information

NPI Number	:	1144091216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI GUTHMILLER

Provider Business Mailing Address
First Line	:	1749 E MULBERRY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-3539
Country	:	US
Telephone Number	:	952-460-0603
Fax Number	:

Provider Business Practice Location Address
First Line	:	1749 E MULBERRY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-3539
Country	:	US
Telephone Number	:	952-460-0603
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2024
Last Update Date	:	01/09/2024

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Directions to “ HEIDI GUTHMILLER ” Practice Location

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