Provider Demographics
NPI:1841413895
Name:GUTIERREZ, HUMBERTO
Entity Type:Individual
Prefix:DR
First Name:HUMBERTO
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S SEMORAN BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3293
Mailing Address - Country:US
Mailing Address - Phone:407-208-1384
Mailing Address - Fax:407-208-1385
Practice Address - Street 1:150 S SEMORAN BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3293
Practice Address - Country:US
Practice Address - Phone:407-208-1384
Practice Address - Fax:407-208-1385
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBUS-0011178111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation