Provider Demographics
NPI:1922115823
Name:GUTIERREZ, FRANCISCO JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:JOSE
Last Name:GUTIERREZ
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 1:300 JEFFERSON BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3860
Mailing Address - Country:US
Mailing Address - Phone:401-388-4256
Mailing Address - Fax:401-388-0137
Practice Address - Street 1:300 JEFFERSON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3860
Practice Address - Country:US
Practice Address - Phone:401-388-4256
Practice Address - Fax:401-396-0137
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
007058907OtherMEDICARE
RI9026544Medicaid
RIH22904Medicare UPIN