Healthcare Provider Details

I. General information

NPI: 1508272220
Provider Name (Legal Business Name): JEFFREY SCOTT GUDES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N
NAPLES FL
34102-5754
US

IV. Provider business mailing address

7295 DANBURY DR
WEST BLOOMFIELD MI
48322-3581
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS18480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: