Healthcare Provider Details

I. General information

NPI: 1821700980
Provider Name (Legal Business Name): CHRISTOPHER M GAITOR PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5664 SW 60TH AVE BLDG 4
OCALA FL
34474-5677
US

IV. Provider business mailing address

108 HIGHLAND ST
ORANGE CITY FL
32763-7017
US

V. Phone/Fax

Practice location:
  • Phone: 813-666-2714
  • Fax: 352-565-4131
Mailing address:
  • Phone: 386-837-4387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11023569
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11023569
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: