Provider Demographics
NPI:1376321745
Name:GUTIERREZ FERRAN, ADRIAN DANIEL SR
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:DANIEL
Last Name:GUTIERREZ FERRAN
Suffix:SR
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 1:6560 NW 7TH ST APT 516
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4477
Mailing Address - Country:US
Mailing Address - Phone:786-508-7733
Mailing Address - Fax:
Practice Address - Street 1:6560 NW 7TH ST APT 516
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4477
Practice Address - Country:US
Practice Address - Phone:786-508-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-298119106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician