Provider Demographics
NPI:1689278897
Name:GUTIERREZ, GIOVANNI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19977 VILLA MEDICI PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5620
Mailing Address - Country:US
Mailing Address - Phone:305-903-5085
Mailing Address - Fax:
Practice Address - Street 1:9940 YAMATO RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-5538
Practice Address - Country:US
Practice Address - Phone:561-488-9838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist