Provider Demographics
NPI:1194990309
Name:GUTIERREZ, MARIA C (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:C
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 SW 37TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3856
Mailing Address - Country:US
Mailing Address - Phone:305-553-7202
Mailing Address - Fax:
Practice Address - Street 1:3197 SW 18TH ST
Practice Address - Street 2:FARMACIA JULIA DISCOUNT #2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-1803
Practice Address - Country:US
Practice Address - Phone:305-448-6523
Practice Address - Fax:305-444-1535
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist