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NPI Code Detail

MEDICARE: DR. CYNTHIA JANE GRIES M.D., MSC

MEDICARE:  DR. CYNTHIA JANE GRIES  M.D., MSC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD438817PA
2207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMD438817PA
3207RP1001XPulmonary Disease PhysicianMD438817PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417904210
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CYNTHIA JANE GRIES M.D., MSC
Provider Business Mailing Address
First Line : PO BOX 100225
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-0225
Country : US
Telephone Number : 352-273-8737
Fax Number : 352-273-9154
Provider Business Practice Location Address
First Line : 1505 SW ARCHER RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-1134
Country : US
Telephone Number : 352-265-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 12/06/2022

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