Individual
JACINTA GAITOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 COUNTY ROAD 17A W, AVON PARK, FL 33825-2164
(863) 452-3000
(863) 452-3069
Mailing address
950 COUNTY ROAD 17A W, AVON PARK, FL 33825-2164
(863) 452-3000
(863) 452-3069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN18140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003063500
—
FL
01
—
DN18140
STATE LICENSE
FL
Enumeration date
08/16/2007
Last updated
03/07/2023
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