Basic Information
| Provider Information | |||||||||
| NPI: | 1770863177 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GAINESVILLE URGENT CARE ASSOCIATES, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18167 US HIGHWAY 19 N | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337643528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275078874 | ||||||||
| FaxNumber: | 7275362896 | ||||||||
| Practice Location | |||||||||
| Address1: | 812 NW 57TH ST | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326056414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523334700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2011 | ||||||||
| LastUpdateDate: | 08/17/2011 | ||||||||
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| AuthorizedOfficialLastName: | GILLETTE | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
| AuthorizedOfficialMiddleName: | W. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8005078874 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.