MEDICARE: GUTIERREZ EQUIPO MEDICO INC

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	332B00000X	Durable Medical Equipment & Medical Supplies		PR

General Provider Information

NPI Number	:	1972501542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUTIERREZ EQUIPO MEDICO INC

Provider Business Mailing Address
First Line	:	URB. TOWN PARK
Second Line	:	B2 CALLE MARGINAL
City	:	SAN JUAN
State	:	PR
Zip	:	00924-5014
Country	:	US
Telephone Number	:	787-293-0937
Fax Number	:	787-293-0998

Provider Business Practice Location Address
First Line	:	URB. TOWN PARK
Second Line	:	B2 CALLE MARGINAL
City	:	SAN JUAN
State	:	PR
Zip	:	00924-5014
Country	:	US
Telephone Number	:	787-293-0937
Fax Number	:	787-293-0998

Authorized Official
Title or Position	:	OWNER
Name	:	NIEVE GUTIERREZ
Credential	:
Telephone Number	:	787-293-0937

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	02/10/2011

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