Provider Demographics
NPI:1578341004
Name:BILLEWICZ GUTIERREZ, KLAUS (SA-C)
Entity Type:Individual
Prefix:
First Name:KLAUS
Middle Name:
Last Name:BILLEWICZ GUTIERREZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 S BISMARK LN APT 306
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8490
Mailing Address - Country:US
Mailing Address - Phone:786-923-6557
Mailing Address - Fax:
Practice Address - Street 1:3227 S BISMARK LN APT 306
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8490
Practice Address - Country:US
Practice Address - Phone:786-923-6557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-592246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant