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Organization
GULFVIEW MEDICAL INSTITUTE PLLC
Active
Organization
GULFVIEW MEDICAL INSTITUTE PLLC
Active
Other names
Premier Medical Institute PL
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH RAVID MD (OWNER)
(941) 505-2100
Entity
Organization
Contact information
Practice address
21942 EDGEWATER DR, PORT CHARLOTTE, FL 33952-9723
(941) 505-2100
(941) 505-6100
Mailing address
21942 EDGEWATER DR STE 1211, PORT CHARLOTTE, FL 33952-9723
(941) 505-2100
(941) 505-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 106244
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003XX
BC/BS
FL
01
—
DS5131
RAIL ROAD MEDICARE
FL
01
—
FB001A
MEDICARE
FL
Enumeration date
03/31/2011
Last updated
06/30/2020
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