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General NPI Number Information
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NPI Number | 1942535059
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Entity Type | Individual
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Provider Name | DR. GERARD DEIB
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Gender | Male
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 910 OLD CAMP RD STE 180
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City | THE VILLAGES
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State | FL
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Zip | 32162-5605
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Country | US
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Telephone | 407-680-2026
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Fax | 407-680-0911
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Provider Business Mailing Address
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Address Line | 9835 LAKE WORTH RD STE 16-143
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City | LAKE WORTH
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State | FL
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Zip | 33467-2300
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Country | US
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Telephone | 407-680-2026
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Fax | 407-680-0911
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME156411
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | ME156411
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License Number State | FL
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