Healthcare Provider Details

I. General information

NPI: 1215094222
Provider Name (Legal Business Name): DOUGLAS E GEARITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/22/2020
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: DOUGLAS E GEARITY
Title or Position: CEOPRESIDENT
Credential: MD
Phone: 407-857-2502