MEDICARE: MICHAEL D GUITERREZ

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	227900000X	Registered Respiratory Therapist	RC200001653	DC
2	227900000X	Registered Respiratory Therapist	RCP02007498	TX
3	227900000X	Registered Respiratory Therapist	RT-1374	HI

General Provider Information

NPI Number	:	1396630026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D GUITERREZ

Provider Business Mailing Address
First Line	:	3136 KELLY ST SW
Second Line	:
City	:	BOLLING AFB
State	:	DC
Zip	:	20032-7465
Country	:	US
Telephone Number	:	805-717-4376
Fax Number	:

Provider Business Practice Location Address
First Line	:	3136 KELLY ST SW
Second Line	:
City	:	BOLLING AFB
State	:	DC
Zip	:	20032-7465
Country	:	US
Telephone Number	:	805-717-4376
Fax Number	:

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

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	06/11/2025

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Directions to “ MICHAEL D GUITERREZ ” Practice Location

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