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NPI 1376502740

NPI 1376502740 : HONG GAO MD : TALLAHASSEE, FL

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General NPI Number Information
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    NPI Number           |    1376502740
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    Entity Type          |    Individual 
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    Provider Name        |    HONG GAO MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/22/2006
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    Last Update Date     |    07/13/2018
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Provider Practice Location Address
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    Address Line         |    2400 MICCOSUKEE RD 
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    City                 |    TALLAHASSEE
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    State                |    FL
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    Zip                  |    32308
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    Country              |    US
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    Telephone            |    850-877-2105
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    Fax                  |    850-216-1321
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Provider Business Mailing Address
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    Address Line         |    2400 MICCOSUKEE RD 
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    City                 |    TALLAHASSEE
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    State                |    FL
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    Zip                  |    32308-5350
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    Country              |    US
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    Telephone            |    850-877-2105
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    Fax                  |    850-216-1321
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RG0100X
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    Taxonomy Name        |    Gastroenterology Physician
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    License Number       |    12665
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    License Number State |    NV
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