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General NPI Number Information
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NPI Number | 1861019028
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Entity Type | Individual
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Provider Name | TINA GAITA CPT
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Gender | Female
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 8237 NW SELVITZ RD UNIT 203
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8270
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Country | US
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Telephone | 631-800-4111
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Fax | 631-204-6842
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Provider Business Mailing Address
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Address Line | 8237 NW SELVITZ RD UNIT 203
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8270
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Country | US
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Telephone | 631-800-4111
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | D3Y4A2S6
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License Number State | NY
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