Individual provider Active NPI

Guillermo Gutierrez

  • Physical Therapist
  • Pinecrest, FL
National Provider Identifier
1821187618
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5204 Issued in FL
Practice address
8603 S Dixie Hwy
Ste 308
Pinecrest, FL 33156-1129
Phone
(305) 661-1441
Fax
(305) 661-1443
NPI assigned
Oct 12, 2006
Last updated
Aug 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5204 FL Primary

Addresses

Primary practice location

8603 S Dixie Hwy
Ste 308
Pinecrest, FL 33156-1129

Mailing address

8603 S Dixie Hwy
Ste 308
Pinecrest, FL 33156-1129
Phone (305) 661-1441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061215000252 FL Practitioner - Physical Therapist in Private Practice 8820097066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dade Physical Therapy IncGroup PAC ID 0244231900, 5 clinicians

Practice addresses (Care Compare)

8603 S Dixie Hwy
Suite 308
Pinecrest, FL 33156-1129
Phone (305) 661-1441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5204FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dade Physical Therapy Inc Physical Therapist CurrentSince Jan 23, 2006 Accepting new patients
Orthopedic Rehabilitation Specialists, Inc. Physical Therapist PastSince Dec 20, 2004 Accepting new patients

Locations

8603 S Dixie Hwy
Ste 308
Pinecrest, FL 33156
Phone (305) 661-1441

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1821187618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8603 S DIXIE HWY",
            "address_2": "STE 308",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331561129",
            "telephone_number": "305-661-1441",
            "fax_number": "305-661-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8603 S DIXIE HWY",
            "address_2": "STE 308",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331561129",
            "telephone_number": "305-661-1441",
            "fax_number": "305-661-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "GUILLERMO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT5204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinecrest, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.