Provider Demographics
NPI:1922821982
Name:ESTEVEZ GUTIERREZ, LISBEL
Entity type:Individual
Prefix:
First Name:LISBEL
Middle Name:
Last Name:ESTEVEZ GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3339 CLOVER BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-8092
Mailing Address - Country:US
Mailing Address - Phone:502-299-2594
Mailing Address - Fax:
Practice Address - Street 1:3339 CLOVER BLOSSOM CIR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-8092
Practice Address - Country:US
Practice Address - Phone:502-299-2594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily