Provider Demographics
NPI:1396990461
Name:GUTIERREZ STONE, JESUS E (MD)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:E
Last Name:GUTIERREZ STONE
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 1:601 S SEMORAN BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3120
Mailing Address - Country:US
Mailing Address - Phone:407-203-6898
Mailing Address - Fax:407-203-6899
Practice Address - Street 1:601 S SEMORAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3120
Practice Address - Country:US
Practice Address - Phone:407-203-6898
Practice Address - Fax:407-203-6899
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17349208D00000X
FLACN447208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice