Provider Demographics
NPI:1083830269
Name:GUTIERREZ, WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N COLLIER BLVD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-2531
Mailing Address - Country:US
Mailing Address - Phone:298-642-0076
Mailing Address - Fax:
Practice Address - Street 1:1000 N COLLIER BLVD
Practice Address - Street 2:SUITE 11
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-2531
Practice Address - Country:US
Practice Address - Phone:298-642-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4597111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70438Medicare UPIN