Organization
BACK2BASICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUMBERTO GUTIERREZ CH (PRESIDENT)
(407) 856-8862
Entity
Organization
Contact information
Practice address
9521 S ORANGE BLOSSOM TRL, SUITE 116, ORLANDO, FL 32837-8327
(407) 856-8862
(407) 856-8863
Mailing address
9521 S ORANGE BLOSSOM TRL, SUITE 116, ORLANDO, FL 32837-8327
(407) 856-8862
(407) 856-8863
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
N/A
FL
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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