MEDICARE: CARLOS M GUTIERREZ-HEVIA 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	207P00000X	Emergency Medicine Physician	ME108020	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1598722753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS M GUTIERREZ-HEVIA MD

Provider Business Mailing Address
First Line	:	2338 IMMOKALEE RD STE 203
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-1445
Country	:	US
Telephone Number	:	239-919-4342
Fax Number	:

Provider Business Practice Location Address
First Line	:	2338 IMMOKALEE RD STE 203
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-1445
Country	:	US
Telephone Number	:	239-919-4342
Fax Number	:

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	10/17/2024

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