Individual
JENNIFER ALSINA GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 KATHLEEN RD, LAKELAND, FL 33810-3077
(863) 284-5000
Mailing address
4715 DIMBATH DR, LAKELAND, FL 33813-2055
(863) 272-0185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116087
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114919700
—
FL
01
—
VB56H
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/29/2020
Last updated
03/22/2024
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