Individual
MICHAEL GEORGE GUTKNECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3660 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
(239) 931-6373
Mailing address
3660 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
(239) 931-6373
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G9747
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02271000
—
FL
01
—
149VC
FLORIDA BLUE CROSS
—
Enumeration date
09/21/2006
Last updated
09/14/2016
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