Individual
SAMUEL GUBERNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
13145 66TH ST N, LARGO, FL 33773
(727) 530-0700
(727) 530-0777
Mailing address
13145 66TH ST N, LARGO, FL 33773
(727) 530-0700
(727) 530-0777
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
OS5550
FL
2080P0201X
Pediatric Allergy/Immunology Physician
OS5550
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372468900
—
FL
Enumeration date
05/10/2006
Last updated
07/08/2019
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