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Pura Isabel Gutierrez Mirabal

Student in an Organized Health Care Education/Training Program

Student, Health Care

PECOS Enrollment

This provider is enrolled in PECOS as PURA GUTIERREZ MIRABAL.

Based on the most recent information from CMS, provider Pura Isabel Gutierrez Mirabal is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 1:10 PM.

Profile Details

Provider ID
1811529944
Provider Type
Individual
Full Name
Gutierrez Mirabal, Pura Isabel
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
2/6/2020
Last Updated
5/23/2023

Contact Information

Practice Location

1 Wyoming St, Dayton, OH 45409-2722

(937) 208-2850

(937) 208-2752

Mailing Location

1 Wyoming St, Berry Ground 020, Dayton, OH 45409-2722

(937) 208-2850

(937) 208-2752

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Pura Isabel Gutierrez Mirabal

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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