Provider Demographics
NPI:1033673751
Name:GUTIERREZ, MAURICE (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MAJORCA WAY APT 102
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-1131
Mailing Address - Country:US
Mailing Address - Phone:305-537-6808
Mailing Address - Fax:
Practice Address - Street 1:110 MAJORCA WAY APT 102
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-1131
Practice Address - Country:US
Practice Address - Phone:305-537-6808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator