Provider Demographics
NPI:1134435159
Name:GUTIERREZ, NOEMI (RNFA)
Entity type:Individual
Prefix:
First Name:NOEMI
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 SW 52ND CIR
Mailing Address - Street 2:UNIT 104
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9787
Mailing Address - Country:US
Mailing Address - Phone:352-362-4959
Mailing Address - Fax:352-873-8140
Practice Address - Street 1:4560 SW 52ND CIR
Practice Address - Street 2:UNIT 104
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9787
Practice Address - Country:US
Practice Address - Phone:352-362-4959
Practice Address - Fax:352-873-8140
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9230222364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative