Organization
THORACIC AND VASCULAR SURGEONS OF GAINESVILLE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD R PROIA MD (PRESIDENT)
(352) 416-2628
Entity
Organization
Contact information
Practice address
1151 NW 64TH TER, GAINESVILLE, FL 32605-4218
(352) 331-8570
(352) 331-9095
Mailing address
PO BOX 14655, GAINESVILLE, FL 32604-4655
(352) 331-9095
(352) 331-9095
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME94028
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME94028
FL
Other
Enumeration date
03/24/2014
Last updated
10/12/2017
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