Healthcare Provider Details
I. General information
NPI: 1285952085
Provider Name (Legal Business Name): LINDSAY MICHELLE GATES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/04/2010
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
410 CELEBRATION PL STE 402
CELEBRATION FL
34747-5436
US
IV. Provider business mailing address
410 CELEBRATION PL STE 402
CELEBRATION FL
34747-5436
US
V. Phone/Fax
- Phone: 407-303-4080
- Fax: 407-303-7255
- Phone: 407-303-4080
- Fax: 407-303-7255
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | MD60636913 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 73246 |
| License Number State | AZ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | ME156231 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | ME156231 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: