Healthcare Provider Details

I. General information

NPI: 1558414706
Provider Name (Legal Business Name): EUGENE GERNIER P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 ORANGE AVE
WINTER PARK FL
32789-4984
US

IV. Provider business mailing address

1285 ORANGE AVE
WINTER PARK FL
32789-4984
US

V. Phone/Fax

Practice location:
  • Phone: 407-647-2287
  • Fax: 407-643-2801
Mailing address:
  • Phone: 407-647-2287
  • Fax: 407-643-2801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9103150
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9103150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: