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General NPI Number Information
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NPI Number | 1477875979
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Entity Type | Individual
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Provider Name | ADAM GARETT GORBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2010
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | 2438 DR MARTIN LUTHER KING JR ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33704
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Country | US
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Telephone | 727-547-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 6227 VISTA VERDE DR W
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City | GULFPORT
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State | FL
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Zip | 33707-6908
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Country | US
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Telephone | 914-450-8504
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101247626
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME102397
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License Number State | FL
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