MEDICARE: ANDRES MICHEL GUTIERREZ MD

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	207Q00000X	Family Medicine Physician	TRN28149	FL
2	207Q00000X	Family Medicine Physician	ME152440	FL

General Provider Information

NPI Number	:	1235796277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRES MICHEL GUTIERREZ MD

Provider Business Mailing Address
First Line	:	1761 NW 123RD AVE
Second Line	:
City	:	PEMBROKE PNES
State	:	FL
Zip	:	33026-3824
Country	:	US
Telephone Number	:	786-890-0799
Fax Number	:

Provider Business Practice Location Address
First Line	:	1761 NW 123RD AVE
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-3824
Country	:	US
Telephone Number	:	786-890-0799
Fax Number	:	754-221-0387

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

Provider Enumeration Date	:	05/24/2019
Last Update Date	:	04/02/2026

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Directions to “ ANDRES MICHEL GUTIERREZ MD” Practice Location

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