Provider Demographics
NPI:1083345094
Name:GUTIERREZ, INDIRA BEATRIZ (APRN-FNP-C)
Entity Type:Individual
Prefix:
First Name:INDIRA
Middle Name:BEATRIZ
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:APRN-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 SW 138TH CT APT L
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2095
Mailing Address - Country:US
Mailing Address - Phone:786-406-2497
Mailing Address - Fax:
Practice Address - Street 1:10651 SW 88TH ST STE 207
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1545
Practice Address - Country:US
Practice Address - Phone:305-275-7373
Practice Address - Fax:305-275-7066
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily