Individual
JAY D. GEWOLB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066
Mailing address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME55713
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME55713
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050066862
RAILROAD MEDICARE
—
05
—
0636517 00
—
FL
01
—
09206
BCBS
FL
01
—
XXX-XX-8006
CHAMPUS / TRICARE SOUTH REGION
—
Enumeration date
07/20/2006
Last updated
01/11/2018
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