MEDICARE: ZAPHYRE GUTIERREZ MSW

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	1041C0700X	Clinical Social Worker	7996	PR

General Provider Information

NPI Number	:	1174621338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAPHYRE GUTIERREZ MSW

Provider Business Mailing Address
First Line	:	CONDOMINIO VEREDAS DE VENUS
Second Line	:	APT. 4301
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-602-3964
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 AVE DE DIEGO
Second Line	:	EDIF. TORRE MUSEO SUITE 301
City	:	SAN JUAN
State	:	PR
Zip	:	00909-1756
Country	:	US
Telephone Number	:	787-217-1337
Fax Number	:

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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