Healthcare Provider Details

I. General information

NPI: 1710074125
Provider Name (Legal Business Name): STEVEN HAROLD GOLLISH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SEMINARY ST
KEY WEST FL
33040-3404
US

IV. Provider business mailing address

1310 SEMINARY ST
KEY WEST FL
33040-3404
US

V. Phone/Fax

Practice location:
  • Phone: 989-240-0221
  • Fax:
Mailing address:
  • Phone: 989-240-0221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME94500
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: