Healthcare Provider Details

I. General information

NPI: 1609827310
Provider Name (Legal Business Name): ADAM CRISTOPHER GERIL PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 E SILVER SPRINGS BLVD SUITE 305
OCALA FL
34470-3228
US

IV. Provider business mailing address

4901 E SILVER SPRINGS BLVD SUITE 305
OCALA FL
34470-3228
US

V. Phone/Fax

Practice location:
  • Phone: 352-236-1811
  • Fax:
Mailing address:
  • Phone: 352-236-1811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT4651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: