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Organization

JOHN C GUTLEBER MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARIA E GUTLEBER (OFFICE MANAGER)
(305) 247-1213
Entity
Organization

Contact information

Practice address
139 NE 15TH ST, HOMESTEAD, FL 33030-4508
(305) 247-1213
(305) 247-5701
Mailing address
139 NE 15TH ST, HOMESTEAD, FL 33030-4508
(305) 247-1213

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME70290
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002435404
UNITED HEALTH CARE
FL
01
1012734
CAREPLUS
FL
01
245462
WELLCARE
FL
05
250356500
FL
01
279472
AVMED
FL
01
31716
BCBS
FL
01
43136
NEIGHBORHOOD HEALTH
FL
01
591593951
STAYWELL
FL
01
7466251
AETNA
FL
Enumeration date
11/28/2007
Last updated
12/05/2014
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