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General NPI Number Information
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NPI Number | 1942399613
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Entity Type | Organization
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Legal Business Name | DEAN J GOBO MD PLC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 430 MORTON PLANT ST SUITE 401
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City | CLEARWATER
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State | FL
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Zip | 33756-3398
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Country | US
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Telephone | 727-298-6121
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Fax | 727-298-6151
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Provider Business Mailing Address
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Address Line | 430 MORTON PLANT ST SUITE 401
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City | CLEARWATER
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State | FL
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Zip | 33756-3398
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Country | US
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Telephone | 727-298-6121
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Fax | 727-298-6151
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | CHARLES COLBASSANI
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Credential |
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Telephone | 727-298-6121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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