Provider Demographics
NPI:1932141538
Name:GUTIERREZ, ORLANDO MARTI (MD)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:MARTI
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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:205-297-9411
Practice Address - Street 1:2000 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2110
Practice Address - Country:US
Practice Address - Phone:205-801-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220307207R00000X, 207RN0300X
FLME101493207RN0300X
AL30625207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051113053OtherBLUE CROSS BLUE SHIELD
AL126702Medicaid
AL126706Medicaid
MS09078744Medicaid
FL0002359-00Medicaid
AL051113052OtherBLUE CROSS & BLUE SHIELD
AL051113054OtherBLUE CROSS & BLUE SHIELD
AL126704Medicaid
FL0002359-00Medicaid
FLAL199Medicare PIN