Individual
ANILEY GUTIERREZ LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBHCM
Contact information
Practice address
1905 NW 82ND AVE, DORAL, FL 33126-1011
(786) 420-5924
Mailing address
1905 NW 82ND AVE, DORAL, FL 33126-1011
(786) 420-5924
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMP100407
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CBHCMP100407
CERTIFICATION LICENSE
FL
Enumeration date
02/21/2020
Last updated
02/21/2020
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