MEDICARE: MS. BARBARA JO GUTSTADT BS,CEA

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	174400000X	Specialist		FL

General Provider Information

NPI Number	:	1881885606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA JO GUTSTADT BS,CEA

Provider Business Mailing Address
First Line	:	11150 HARBOUR YACHT CT
Second Line	:	C
City	:	FORT MYERS
State	:	FL
Zip	:	33908-1150
Country	:	US
Telephone Number	:	239-823-0904
Fax Number	:	239-433-5977

Provider Business Practice Location Address
First Line	:	11150 HARBOUR YACHT CT
Second Line	:	C
City	:	FORT MYERS
State	:	FL
Zip	:	33908-1150
Country	:	US
Telephone Number	:	239-823-0904
Fax Number	:	239-433-5977

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

Provider Enumeration Date	:	08/06/2007
Last Update Date	:	08/06/2007

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