Organization Active NPI

Gutleber Administration Inc

  • General Practice Physician
  • Homestead, FL
National Provider Identifier
1730602210
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
GUTLEBER ADMINISTRATION INC
Practice address
139 NE 15TH St
Homestead, FL 33030-4508
Phone
(305) 247-1213
Fax
(305) 247-5701
NPI assigned
Jul 17, 2017
Last updated
Jun 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Authorized official

Name
Ms. Maria Elena Gutleber
Title
President
Phone
(305) 247-1213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

139 NE 15TH St
Homestead, FL 33030-4508

Mailing address

139 NE 15TH St
Homestead, FL 33030-4508
Phone (305) 247-1213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180212001629 FL Part B Supplier - Clinic/Group Practice 6204196231 Receives reassigned benefits from 3 practitioners
Practice locations: Homestead, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1106670Gutleber Administration139 NE 15TH St, Homestead, FL 33030Certificate of waiverOct 19, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1730602210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 NE 15TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304508",
            "telephone_number": "305-247-1213",
            "fax_number": "305-247-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 NE 15TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304508",
            "telephone_number": "305-247-1213",
            "fax_number": "305-247-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTLEBER ADMINISTRATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "GUTLEBER",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-247-1213",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.