Provider Type Icon

PREVENTIVE MEDICINE CTR OF GAINESVILLE INC NPI 1063546133


NPI Information

NPI: 1063546133
Provider Name: PREVENTIVE MEDICINE CTR OF GAINESVILLE INC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
905 NW 56TH TERRACE
SUITE B
GAINESVILLE, FL
ZIP 32605
Phone: (352) 331-5138
Get Directions

PREVENTIVE MEDICINE CTR OF GAINESVILLE INC is a specialist in Gainesville, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PREVENTIVE MEDICINE CTR OF GAINESVILLE INC NPI is 1063546133. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

905 NW 56TH TERRACE
SUITE B
GAINESVILLE, FL
ZIP 32605
Phone: (352) 331-5138
Fax: (352) 331-9399

The provider's authorized official is Robert A Erickson .
The authorized official title is Medical Director and has the following contact phone number (352) 331-5138.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ME22324OTHERFLORIDASTATE ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.