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Individual
MR. GARY JAMES
Active
Individual
MR. GARY JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9110289
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022838200
—
FL
01
—
JE476Y
MEDICARE
FL
01
—
JE476Z
MEDICARE
FL
Enumeration date
05/10/2006
Last updated
01/03/2018
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