Provider Demographics
NPI:1821218470
Name:GUTIERREZ, INDIANA DEL PILAR (AUD)
Entity Type:Individual
Prefix:DR
First Name:INDIANA
Middle Name:DEL PILAR
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11360 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4414
Mailing Address - Country:US
Mailing Address - Phone:954-437-0817
Mailing Address - Fax:
Practice Address - Street 1:10081 PINES BLVD STE E1
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6171
Practice Address - Country:US
Practice Address - Phone:954-435-9779
Practice Address - Fax:954-450-5375
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAZ496231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist