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Individual

DR. OLINDA R. GAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 202-8275
(904) 390-3429
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME74935
FL
207LP3000X
Pediatric Anesthesiology Physician
Primary
ME74935
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000798597A
GA
05
254627200
FL
Enumeration date
08/10/2006
Last updated
09/10/2011
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