Individual
DR. PATRICK W GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
111 N LAKEMONT AVE STE 2D, WINTER PARK, FL 32792-3217
(407) 644-7792
(407) 644-3509
Mailing address
111 N LAKEMONT AVE STE 2D, WINTER PARK, FL 32792-3217
(407) 644-7792
(407) 644-3509
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY5141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051159
CIGNA BEHAVIORAL HEALTH
FL
01
—
59686
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/12/2005
Last updated
03/04/2019
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