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General NPI Number Information
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NPI Number | 1588976252
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Entity Type | Organization
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Legal Business Name | R J GAMAD M.D.,P.A.
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 3232 E 15TH ST
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City | PANAMA CITY
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State | FL
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Zip | 32405-7423
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Country | US
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Telephone | 850-769-1533
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Fax | 850-785-1189
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Provider Business Mailing Address
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Address Line | 3232 E 15TH ST
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City | PANAMA CITY
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State | FL
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Zip | 32405-7423
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Country | US
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Telephone | 850-769-1533
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Fax | 850-785-1189
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ROGELIO JINCO GAMAD
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Credential | M.D.
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Telephone | 850-769-1533
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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 | ME0021270
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License Number State | FL
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