Individual provider Active NPI

Luis C Gutierrez, MD

  • Psychiatry Physician
  • Bradenton, FL
National Provider Identifier
1801882022
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME29652 Issued in FL
Practice address
379 6TH Ave W
Bradenton, FL 34205-8820
Phone
(941) 782-4259
Fax
(941) 782-4101
NPI assigned
Sep 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME29652 FL Primary

Addresses

Primary practice location

379 6TH Ave W
Bradenton, FL 34205-8820

Mailing address

379 6TH Ave W
Bradenton, FL 34205-8820
Phone (941) 782-4259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000654 FL Practitioner - Psychiatry 9739376419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME29652FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Behavioral Health Center, Inc. CurrentSince Aug 23, 2016 Accepting new patients
Florida Hospital Medical Group Inc Past Accepting new patients

Locations

12512 Bruce B Downs Blvd
Tampa, FL 33612
Phone (813) 977-8700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1801882022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058820",
            "telephone_number": "941-782-4259",
            "fax_number": "941-782-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058820",
            "telephone_number": "941-782-4259",
            "fax_number": "941-782-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "LUIS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME29652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.