Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 28394-R | PR |
Y | 207Q00000X | Family Doctor | ME115832 | FL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | ME115832 | FL |
NPI | 1063742740 |
---|---|
Provider Name | Amaury Guerra Gutierrez |
First Address | Miramar, FL 33027-6314 |
Second Address | Miramar, FL 33027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2010 |
Last Update Date | 13/05/2019 |