Edwin G Guttery III, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME15966 Issued in FL

Practice address

9350 Camelot Dr
Fort Myers, FL 33919-7980

Phone

(239) 481-5437

Fax

(239) 481-1902

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physicians Primary Care of Southwest Florida PL

  • General Practice Physician
  • Fort Myers, FL
  • NPI 1356336705

  Pediatrics

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1215919469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13740 CYPRESS TERRACE CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078827",
            "telephone_number": "239-275-5522",
            "fax_number": "239-275-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 CAMELOT DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339197980",
            "telephone_number": "239-481-5437",
            "fax_number": "239-481-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTERY",
        "first_name": "EDWIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME15966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054034000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF FLORIDA",
            "identifier": "36195",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "212078",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "000013683B",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL",
            "identifier": "27098",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lizandra C Gutierrez, RBT
• Michael George Gutknecht, M.D.
• Barbara Jo Gutstadt, BS,CEA
• David M Gutstein, M.D.
• Laurie Lynn Gutstein, MD
• Germaine Guy, MS, RDN, LDN
• Ahmeed Alejandro Guzman Garcet
• Yirandy Beyanirys Guzman Perez, RBT-25-429422
• Camilo Enrique Guzman, MD
• Daniel Guzman

• Pediatrics Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.