MEDICARE: ESTEFANY GUTIERRESZ

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	225X00000X	Occupational Therapist	27124	FL
2	225XP0200X	Pediatric Occupational Therapist	OTA16498	FL

General Provider Information

NPI Number	:	1912889130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTEFANY GUTIERRESZ

Provider Business Mailing Address
First Line	:	8450 LAGOS DE CAMPO BLVD APT 301
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-3739
Country	:	US
Telephone Number	:	954-899-8166
Fax Number	:

Provider Business Practice Location Address
First Line	:	8450 LAGOS DE CAMPO BLVD APT 301
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-3739
Country	:	US
Telephone Number	:	954-899-8166
Fax Number	:

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

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	05/20/2026

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Directions to “ ESTEFANY GUTIERRESZ ” Practice Location

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