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NPI Code Detail

MEDICARE: RUBEN GUTIERREZ JR.

MEDICARE: RUBEN GUTIERREZ JR.
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 TechnicianCA

General Provider Information

NPI Number : 1649120676
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBEN GUTIERREZ JR.
Provider Business Mailing Address
First Line : 350 FAIRWAY DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number : 877-418-2978
Fax Number : 866-500-2186
Provider Business Practice Location Address
First Line : 501 W BROADWAY STE 800
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-3546
Country : US
Telephone Number : 877-418-2978
Fax Number : 866-500-2186
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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Directions to “ RUBEN GUTIERREZ JR. ” Practice Location

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