MEDICARE: KATIE GUTIERREZ

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	363LF0000X	Family Nurse Practitioner	APRN11042412	FL

General Provider Information

NPI Number	:	1285508275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE GUTIERREZ

Provider Business Mailing Address
First Line	:	12109 COUNTY ROAD 103
Second Line	:
City	:	OXFORD
State	:	FL
Zip	:	34484-2951
Country	:	US
Telephone Number	:	352-504-4623
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 MEASE DR STE 300
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-6605
Country	:	US
Telephone Number	:	727-785-6011
Fax Number	:

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

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	01/08/2026

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Directions to “ KATIE GUTIERREZ ” Practice Location

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