Individual
DR. PAUL W. GONTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
836 SUNSET LAKE BLVD, SUITE 101, VENICE, FL 34292-7554
(941) 408-0500
(941) 496-8558
Mailing address
PO BOX 102222, ATTN: CREDENTIAL DEPARTMENT, ATLANTA, GA 30368-2222
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME85932
FL
207RX0202X
Medical Oncology Physician
Primary
ME85932
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252556900
—
FL
Enumeration date
11/02/2005
Last updated
05/03/2022
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