Provider Demographics
NPI:1083403786
Name:GUTIERREZ, ISABEL ALEXANDREA (DOM, AP)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:ALEXANDREA
Last Name:GUTIERREZ
Suffix:
Gender:
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SW 52ND CT
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1132
Mailing Address - Country:US
Mailing Address - Phone:407-715-8343
Mailing Address - Fax:
Practice Address - Street 1:8726 NW 26TH ST STE 12
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1628
Practice Address - Country:US
Practice Address - Phone:305-599-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4612171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty