Organization
JOHNNY GURGEN DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY GURGEN (OWNER)
(352) 435-7695
Entity
Organization
Contact information
Practice address
920 ROLLING ACRES RD UNIT 203, LADY LAKE, FL 32159-5029
(352) 435-7695
(352) 435-7453
Mailing address
920 ROLLING ACRES RD UNIT 203, LADY LAKE, FL 32159-5029
(352) 435-7695
(352) 435-7453
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
02/20/2012
Last updated
11/18/2019
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