Lissette Gutierrez, MD

Individual provider Active NPI Obstetrics & Gynecology Physician · Carolina, PR

NPI 1962482885 · NPPES record last updated Nov 17, 2021

Key facts

NPI
1962482885
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
13364 (PR)
Practice address
Plazoleta la Ceramica Suite 2 Al 6
Ave Sanchez Vilella Esquina PR-190
Carolina, PR 00983
Phone
(855) 711-2673
NPI assigned
Jan 18, 2006
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 fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13364PRMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A.Collazo MD, CSP Past Accepting new patients
Armando James Collazo Leandry CSP Obstetrics & Gynecology Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 13364 PR Yes

Addresses

Primary practice location

Plazoleta la Ceramica Suite 2 Al 6
Ave Sanchez Vilella Esquina PR-190
Carolina, PR 00983

Mailing address

12955 SW 68TH Ave
Pinecrest, FL 33156-6259
Phone (787) 360-4751

Other providers in Carolina, PR

All providers in Carolina, PR · Obstetrics & Gynecology Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.