Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 01051753 | IN |
Y | 2080P0208X | Pediatric Infectious Diseases | ME73788 | FL |
NPI | 1083605380 |
---|---|
Provider Name | Dr. Liliana D Gutierrez |
First Address | Orlando, FL 32806-1141 |
Second Address | Orlando, FL 32806-1141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 10/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200352190 | (05) | IN |
275347200 | (05) | FL |
ME73788 | MEDICAL LICENSE (01) | FL |