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General NPI Number Information
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NPI Number | 1548208465
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE CENTER OF PLANT CITY P A
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 507 W ALEXANDER ST
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City | PLANT CITY
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State | FL
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Zip | 33563-7136
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Country | US
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Telephone | 813-754-3504
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Fax | 813-752-6863
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Provider Business Mailing Address
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Address Line | 507 W ALEXANDER ST
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City | PLANT CITY
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State | FL
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Zip | 33563-7136
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Country | US
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Telephone | 813-754-3504
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Fax | 813-752-6863
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | GREGG W. GUTOWSKI
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Credential | M.D.
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Telephone | 813-754-3504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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