Individual
GUSTAVO REY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2776 CLEVELAND AVE, FORT MYERS, FL 33901-5864
(239) 343-3292
(239) 343-3695
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3292
(239) 343-3695
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME147857
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN26893
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110370200
—
FL
Enumeration date
07/05/2018
Last updated
11/10/2021
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