MEDICARE: ALBERTO G 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
1	122300000X	Dentist

General Provider Information

NPI Number	:	1780736512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERTO G GUTIERREZ

Provider Business Mailing Address
First Line	:	1836 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010
Country	:	US
Telephone Number	:	305-887-8844
Fax Number	:	305-887-6344

Provider Business Practice Location Address
First Line	:	1836 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010
Country	:	US
Telephone Number	:	305-887-8844
Fax Number	:	305-887-6344

Authorized Official
Title or Position	:	DENTIST
Name	:	ALBERTO G GUITERREZ SR.
Credential	:	DDS
Telephone Number	:	305-887-8844

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	02/10/2015

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