Basic Information
| Provider Information | |||||||||
| NPI: | 1538120803 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REISFIELD | ||||||||
| FirstName: | GARY | ||||||||
| MiddleName: | MITCHEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF PSYCHIATRY | ||||||||
| Address2: | BOX 100256 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522657981 | ||||||||
| FaxNumber: | 3522657981 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 SW ARCHER RD | ||||||||
| Address2: | BOX 100256 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522657981 | ||||||||
| FaxNumber: | 3522657983 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2006 | ||||||||
| LastUpdateDate: | 03/07/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME54511 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | ME54511 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 2084P0800X | ME54511 | FL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 207LA0401X | ME54511 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Addiction Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00140464 | 01 | FL | RAILROAD MEDICARE | OTHER | 152680155A | 05 | GA | MEDICAID | 2704137-00 | 05 | FL | MEDICAID |