Organization
CRESTSIDE EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH H GATEWOOD MD (PRESIDENT)
(727) 507-2513
Entity
Organization
Contact information
Practice address
700 MEDICAL BLVD, ENGLEWOOD, FL 34223-3964
(941) 475-6571
Mailing address
PO BOX 37903, PHILADELPHIA, PA 19101-0403
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
10/17/2012
Last updated
07/05/2013
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