MEDICARE: ROSEMARY GUTIERREZ MS

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	101YM0800X	Mental Health Counselor	32179	FL

General Provider Information

NPI Number	:	1144102773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY GUTIERREZ MS

Provider Business Mailing Address
First Line	:	5621 NE 22ND AVE APT 6
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2692
Country	:	US
Telephone Number	:	352-339-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 N OCEAN BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6424
Country	:	US
Telephone Number	:	352-339-9700
Fax Number	:

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

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	07/24/2025

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