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NPI Code Detail

MEDICARE: LUIS ANTONIO GUTIERREZ MD

MEDICARE:   LUIS ANTONIO 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
12086S0122XPlastic and Reconstructive Surgery Physician15112FL

General Provider Information

NPI Number : 1447568639
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS ANTONIO GUTIERREZ MD
Provider Business Mailing Address
First Line : 2101 CAMPINDIAN HEAD RD.
Second Line :
City : LAND O' LAKES
State : FL
Zip : 34634-0000
Country : US
Telephone Number : 813-948-9166
Fax Number :
Provider Business Practice Location Address
First Line : 2101 CAMPINDIAN HEAD RD.
Second Line :
City : LAND O' LAKES
State : FL
Zip : 34634-0000
Country : US
Telephone Number : 813-948-9166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2010
Last Update Date : 09/22/2010

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Directions to “ LUIS ANTONIO GUTIERREZ MD” Practice Location

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