Healthcare Provider Details

I. General information

NPI: 1407181100
Provider Name (Legal Business Name): GATOR EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 NEWBERRY RD
GAINESVILLE FL
32605-4309
US

IV. Provider business mailing address

18167 US HIGHWAY 19 N
CLEARWATER FL
33764-3528
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-4900
  • Fax: 352-333-4198
Mailing address:
  • Phone: 727-507-3633
  • Fax: 727-536-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH H GATEWOOD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 214-712-2000