Provider Demographics
NPI:1528631462
Name:GUTIERREZ TURINO, GANNELIN (APRN)
Entity type:Individual
Prefix:
First Name:GANNELIN
Middle Name:
Last Name:GUTIERREZ TURINO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 MIAMI LAKES DR APT E107
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6840
Mailing Address - Country:US
Mailing Address - Phone:305-505-7050
Mailing Address - Fax:
Practice Address - Street 1:7100 W 20TH AVE STE 606
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1824
Practice Address - Country:US
Practice Address - Phone:305-505-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily