Individual
GREGORY DAVID PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
1009 MAITLAND CENTER COMMONS BLVD STE 212, MAITLAND, FL 32751-7270
(407) 636-3532
(407) 540-9552
Mailing address
1009 MAITLAND CENTER COMMONS BLVD STE 212, MAITLAND, FL 32751-7270
(407) 636-3532
(407) 540-9552
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002803500
—
FL
05
—
0141785-00
—
FL
Enumeration date
04/03/2015
Last updated
12/01/2015
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