Provider Demographics
NPI:1881467637
Name:GUTIERREZ TORO, JAVIER ANDRES (MD)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:ANDRES
Last Name:GUTIERREZ TORO
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 596
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0596
Mailing Address - Country:US
Mailing Address - Phone:787-383-3928
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE NELSON PEREA
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4948
Practice Address - Country:US
Practice Address - Phone:787-265-3650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23555208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty