Provider Demographics
NPI:1598803470
Name:JEAN-CHARLES, GUTTERIDGE (MD)
Entity Type:Individual
Prefix:MR
First Name:GUTTERIDGE
Middle Name:
Last Name:JEAN-CHARLES
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:P.O. BOX 617440
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861
Mailing Address - Country:US
Mailing Address - Phone:407-914-2325
Mailing Address - Fax:407-826-1592
Practice Address - Street 1:1781 PARK CENTER DRIVE
Practice Address - Street 2:SUITE 120
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6254
Practice Address - Country:US
Practice Address - Phone:407-914-2325
Practice Address - Fax:407-826-1592
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211338207R00000X
FLME102281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine