Healthcare Provider Details

I. General information

NPI: 1730191057
Provider Name (Legal Business Name): PATRICIA GEHART ZEBOOKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER ROAD VA PRIMARY CARE DERMATOLOGY CLINIC
GAINESVILLE FL
32608
US

IV. Provider business mailing address

1601 SW ARCHER ROAD
GAINESVILLE FL
32608
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax: 352-374-6176
Mailing address:
  • Phone: 352-376-1611
  • Fax: 352-374-6176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME47135
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME47135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: