Gutierrez, Eddy Jose

Gutierrez, Eddy Jose is an individual health care provider with primary practice located at 1443 San Marco Blvd Ste 101 , Jacksonville FL 32207-8535. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Gutierrez, Eddy Jose can be contacted via phone (904) 253-6910.

Contact Information

Primary practice address
1443 San Marco Blvd Ste 101 Jacksonville FL 32207-8535
Phone: (904) 253-6910
Fax: (904) 253-6964
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 84110 Georgia
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME132154 Florida
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 84110 Georgia
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X ME132154 Florida

Profile Details

NPI number 1790042513
LBN Legal business name Gutierrez, Eddy Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2012
Last updated Aug 20th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790042513 NPPES
Florida MEDICAID 20495400

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