Organization
COBBLESTONE EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GATEWOOD (PRESIDENT)
(214) 712-2000
Entity
Organization
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5784
(904) 819-5155
Mailing address
18167 US HIGHWAY 19 N, SUITE 285, CLEARWATER, FL 33764-3528
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00431
BLUE SHIELD
FL
Enumeration date
02/21/2007
Last updated
04/20/2008
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