Organization
JOSE A GAUDIER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA E ALEN (PRINCIPAL OFFICER)
(352) 732-8630
Entity
Organization
Contact information
Practice address
1805 SE 16TH AVE, SUITE 1202, OCALA, FL 34471-4670
(352) 732-8630
(352) 867-7895
Mailing address
PO BOX 5277, OCALA, FL 34478-5277
(352) 732-7095
(352) 867-7895
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME0060291
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055513400
—
FL
01
—
12485
BLUE CROSS
FL
01
—
214728
AVMED
FL
01
—
22593
WELLCARE
FL
01
—
7218232004
CIGNA
FL
01
—
DF6521
RR MEDICARE
FL
Enumeration date
10/17/2006
Last updated
03/09/2012
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