Individual
MICHAEL L GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6716 NW 11TH PLACE, STE 200, GAINESVILLE, FL 32605-4215
(352) 331-9729
(352) 331-0136
Mailing address
6716 NW 11TH PLACE, STE 200, GAINESVILLE, FL 32605-4215
(352) 331-9729
(352) 331-0136
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106653
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006304500
—
FL
01
—
P01080536
RAILROAD MEDICARE
FL
01
—
P01080540
RAILROAD MEDICARE
FL
01
—
Y0C4P
BCBS FL
FL
Enumeration date
05/24/2012
Last updated
04/19/2022
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