MEDICARE: DR. JOSE F 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
1	207V00000X	Obstetrics & Gynecology Physician	0043084	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891894325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE F GUTIERREZ MD

Provider Business Mailing Address
First Line	:	6001 VINELAND RD
Second Line	:	SUITE #101
City	:	ORLANDO
State	:	FL
Zip	:	32819-7829
Country	:	US
Telephone Number	:	407-352-0573
Fax Number	:	407-363-6899

Provider Business Practice Location Address
First Line	:	6001 VINELAND RD
Second Line	:	SUITE #101
City	:	ORLANDO
State	:	FL
Zip	:	32819-7829
Country	:	US
Telephone Number	:	407-352-0573
Fax Number	:	407-363-6899

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/16/2012

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