Nicholas Gutierrez, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL 4367 Issued in FL

Practice address

449 W 23Rd St
Panama City, FL 32405-4507

Phone

(850) 769-8341

NPI assigned

Apr 12, 2016

Last updated

Apr 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1902260292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SANTA ROSA BLVD UNIT 519",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485900",
            "telephone_number": "850-896-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054507",
            "telephone_number": "850-769-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 4367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulf Pharmacy Corp (Gulf Coast Pharmacy)
• Lance E Gunning, MS, ATC, LAT, LPTA
• Ashish K Gupta, MD
• Maggie Leigh Gurley
• Matthew Gurney, DC
• Sara Elizabeth Guy, DNP
• Christina Roxanne Guzman, PA-C
• Christopher Emil Haberman, M.D.
• Matthew Louis Hablitzel, DDS MS
• Skye Singletary Haddock, DPT

• Athletic Trainer in Panama City, FL
• Providers in Panama City, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.