Individual
KENNER GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
13595 SW 134TH AVE STE 207, MIAMI, FL 33186-4580
(786) 218-7690
(305) 259-6778
Mailing address
13595 SW 134TH AVE STE 207, MIAMI, FL 33186-4580
(786) 218-7690
(305) 259-6778
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26844
FL
225700000X
Massage Therapist
MA 64023
FL
Other
Enumeration date
12/08/2011
Last updated
03/21/2024
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