Provider Demographics
NPI:1639921760
Name:ARCI GUTIERREZ, MASIEL
Entity Type:Individual
Prefix:
First Name:MASIEL
Middle Name:
Last Name:ARCI GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17720 NW 55TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3528
Mailing Address - Country:US
Mailing Address - Phone:786-973-9146
Mailing Address - Fax:
Practice Address - Street 1:7500 NW 25TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1721
Practice Address - Country:US
Practice Address - Phone:305-909-4872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician