Provider Demographics
NPI:1184095945
Name:GUTIERREZ, GISELLE ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:GISELLE
Middle Name:ELIZABETH
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SW 57TH AVE
Mailing Address - Street 2:STE 224
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5528
Mailing Address - Country:US
Mailing Address - Phone:305-668-6018
Mailing Address - Fax:
Practice Address - Street 1:7800 SW 57TH AVE
Practice Address - Street 2:STE 224
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5528
Practice Address - Country:US
Practice Address - Phone:305-668-6018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9413103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical