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NPI Code Detail

MEDICARE: DR. CALVIN LEROY GUTIERREZ MD

MEDICARE: DR. CALVIN LEROY 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
12085R0202XDiagnostic Radiology PhysicianME157042FL
2208D00000XGeneral Practice PhysicianME157042FL

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 : 1730708660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CALVIN LEROY GUTIERREZ MD
Provider Business Mailing Address
First Line : 4581 WESTON RD
Second Line : BOX 327
City : WESTON
State : FL
Zip : 33331-3141
Country : US
Telephone Number : 305-654-5221
Fax Number : 305-654-6872
Provider Business Practice Location Address
First Line : 160 NW 170TH ST
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33169-5521
Country : US
Telephone Number : 305-651-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 06/08/2026

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