Individual provider Active NPI

Tiffany Gutierrez, MS, CCC-SLP

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1760617575
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA10478 Issued in FL
Practice address
12502 Usf Pine Dr
Tampa, FL 33612
Phone
(813) 972-2250
NPI assigned
May 22, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA10478FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Living Inc. Speech-Language Pathologist Past Accepting new patients
Independent Living Inc. PastSince Nov 26, 2023 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA10478 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

12502 Usf Pine Dr
Tampa, FL 33612

Mailing address

12502 Usf Pine Dr
Tampa, FL 33612-9411
Phone (813) 972-2250

Other practice location 1

6508 Gunn Hwy
Tampa, FL 33625-4022
Phone (813) 963-6923 ext. 235

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 23, 2019.

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1760617575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12502 USF PINE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129411",
            "telephone_number": "813-972-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12502 USF PINE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-972-2250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6508 Gunn Hwy",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336254022",
            "country_code": "US",
            "telephone_number": "813-963-6923 x235",
            "fax_number": "813-264-0768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "TIFFANY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA10478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.