Individual
VICTOR H GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3680 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
Mailing address
3660 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS4069
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001907
AETNA HMO
—
05
—
253664100
—
FL
01
—
4313421
AETNA PPO
—
01
—
57595
BCBS
—
01
—
OS4069
FLORIDA LICENSE
FL
Enumeration date
06/03/2006
Last updated
05/28/2008
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