Individual
MR. GERALD J FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12464 INDIAN ROCKS RD, LARGO, FL 33774-3005
(727) 596-1815
(727) 593-0002
Mailing address
12464 INDIAN ROCKS RD, LARGO, FL 33774-3005
(727) 596-1815
(727) 593-0002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS0007067
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105649
UNITED
FL
01
—
080124319
RAILROAD MEDICARE
FL
01
—
57246
BCBS
FL
01
—
5778427
AETNA
FL
01
—
811456
FIRST
FL
Enumeration date
08/28/2007
Last updated
07/01/2013
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