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NPI Code Detail

MEDICARE: JANIA GUTIERREZ

MEDICARE:   JANIA  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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588314314
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANIA GUTIERREZ
Provider Business Mailing Address
First Line : 4655 PALM AVE APT 130
Second Line :
City : HIALEAH
State : FL
Zip : 33012-4049
Country : US
Telephone Number : 786-712-2533
Fax Number :
Provider Business Practice Location Address
First Line : 4655 PALM AVE APT 130
Second Line :
City : HIALEAH
State : FL
Zip : 33012-4049
Country : US
Telephone Number : 786-712-2533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2022
Last Update Date : 03/25/2022

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Directions to “ JANIA GUTIERREZ ” Practice Location

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