# ANDREW GIBSON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932432093
- **Authorized official:** ANDREW GIBSON PA-C (OWNER)
- **Authorized official phone:** (904) 998-0997

## Contact information

- **Practice address:** 12869 DUNES CT, JACKSONVILLE, FL 32225-3889
- **Practice address phone:** (904) 998-0997
- **Practice address fax:** (904) 824-2226
- **Mailing address:** 12869 DUNES CT, JACKSONVILLE, FL 32225-3889
- **Mailing address phone:** (904) 998-0997
- **Mailing address fax:** (904) 824-2226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | PA2492 | FL | Yes |

## Other

- **Enumeration date:** 09/08/2009
- **Last updated:** 09/08/2009