MEDICARE: DR. DEAN J GOBO MD

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
1	207T00000X	Neurological Surgery Physician	ME70807	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01024476	OTHER	FL	MEDICARE RAILROAD PROVIDER NUMBER

Other Identifiers

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

General Provider Information

NPI Number	:	1518958776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEAN J GOBO MD

Provider Business Mailing Address
First Line	:	400 PINELLAS ST STE 325
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3320
Country	:	US
Telephone Number	:	727-298-6121
Fax Number	:	727-298-6151

Provider Business Practice Location Address
First Line	:	400 PINELLAS ST
Second Line	:	SUITE 325
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3312
Country	:	US
Telephone Number	:	727-298-6121
Fax Number	:	727-533-5903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	04/04/2022

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