Individual
GINO ALBERTO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12831 NW CINNAMON WAY, PALM CITY, FL 34990-4880
(772) 807-5531
Mailing address
12831 NW CINNAMON WAY, PALM CITY, FL 34990-4880
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02001921A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000112218
ANTHEM
IN
05
—
200289160
—
IN
Enumeration date
08/30/2006
Last updated
06/22/2016
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