Healthcare Provider Details

I. General information

NPI: 1104802842
Provider Name (Legal Business Name): DOUGLAS EDWARD GEARITY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HUNTERS CREEK BLVD
ORLANDO FL
32837-6901
US

IV. Provider business mailing address

3000 HUNTERS CREEK BLVD
ORLANDO FL
32837-6901
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-2502
  • Fax: 407-857-1855
Mailing address:
  • Phone: 407-857-2502
  • Fax: 407-857-1855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME68039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: