Healthcare Provider Details
I. General information
NPI: 1386830479
Provider Name (Legal Business Name): ARTURO GAMEZ M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/21/2007
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2115 SE LENNARD RD
PORT SAINT LUCIE FL
34952-4742
US
IV. Provider business mailing address
2115 SE LENNARD RD
PORT SAINT LUCIE FL
34952-4742
US
V. Phone/Fax
- Phone: 772-335-1812
- Fax: 772-335-1825
- Phone: 772-335-1812
- Fax: 772-335-1825
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME 104786 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: