Healthcare Provider Details

I. General information

NPI: 1972743771
Provider Name (Legal Business Name): FLORIDA EM-I MEDICAL SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 COLLEGE RD
KEY WEST FL
33040-4342
US

IV. Provider business mailing address

18167 US HIGHWAY 19 N
CLEARWATER FL
33764-3528
US

V. Phone/Fax

Practice location:
  • Phone: 305-294-5065
  • Fax: 305-294-8065
Mailing address:
  • Phone: 727-507-3633
  • Fax: 727-536-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH H GATEWOOD
Title or Position: PRESIDENT / GENERAL PARTNER
Credential: MD
Phone: 214-712-2000