Provider Demographics
NPI:1427555960
Name:GUTIERREZ LEDESMA, ARMANDO
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:GUTIERREZ LEDESMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8731 CARIBBEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7129
Mailing Address - Country:US
Mailing Address - Phone:786-853-7738
Mailing Address - Fax:
Practice Address - Street 1:8731 CARIBBEAN BLVD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7129
Practice Address - Country:US
Practice Address - Phone:786-853-7738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician