Individual
DR. SAMMY ARNOLD GAMMENTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1815 SALK AVE, TAVARES, FL 32778-4311
(352) 343-1158
(352) 343-8106
Mailing address
PO BOX 1289, TAVARES, FL 32778-1289
(352) 343-1158
(352) 343-8106
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
063196
GA
207RC0000X
Cardiovascular Disease Physician
38340
NC
207RC0000X
Cardiovascular Disease Physician
Primary
ME108483
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014122900
—
FL
01
—
127F2
BCBS NC INDIVIDUAL ID #
NC
01
—
14H8K
BCBS OF FL
FL
05
—
89127F2
—
NC
05
—
908091490A
—
GA
Enumeration date
06/01/2005
Last updated
03/19/2015
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