Provider Demographics
NPI:1235796277
Name:GUTIERREZ, ANDRES MICHEL (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:MICHEL
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6760 NW 199TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2417
Mailing Address - Country:US
Mailing Address - Phone:786-307-5133
Mailing Address - Fax:
Practice Address - Street 1:8374 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6616
Practice Address - Country:US
Practice Address - Phone:954-429-6986
Practice Address - Fax:954-429-6987
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN28149207Q00000X
FLME152440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine