MEDICARE: DR. JULIUS A. GOROSPE M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME77263	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	NE887	OTHER	FL	MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1215999842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIUS A. GOROSPE M.D.

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE FL 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9342
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:	239-599-2612

Provider Business Practice Location Address
First Line	:	7751 BAYMEADOWS RD E STE H
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-5836
Country	:	US
Telephone Number	:	904-425-6963
Fax Number	:	904-674-0155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	01/27/2021

7751 BAYMEADOWS RD E STE 205
JACKSONVILLE, FL
32256-5836

Practice Phone: 904-427-1050
Practice Fax:

7751 BAYMEADOWS RD E STE H
JACKSONVILLE, FL
32256-5836