Provider Demographics
NPI:1275337404
Name:GUTIERREZ HURTADO, LAURA MERCEDES
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MERCEDES
Last Name:GUTIERREZ HURTADO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9379 W 32ND LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2063
Mailing Address - Country:US
Mailing Address - Phone:954-812-1642
Mailing Address - Fax:
Practice Address - Street 1:9379 W 32ND LN
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-2063
Practice Address - Country:US
Practice Address - Phone:954-812-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician