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General NPI Number Information
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NPI Number | 1871785469
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Entity Type | Individual
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Provider Name | JACINTA GAITOR
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Gender | Female
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 950 COUNTY ROAD 17A W
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City | AVON PARK
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State | FL
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Zip | 33825-2164
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Country | US
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Telephone | 863-452-3000
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Fax | 863-452-3069
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Provider Business Mailing Address
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Address Line | 950 COUNTY ROAD 17A W
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City | AVON PARK
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State | FL
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Zip | 33825-2164
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Country | US
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Telephone | 863-452-3000
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Fax | 863-452-3069
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN18140
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License Number State | FL
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