Organization
GAYNOR MEDICAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GAYNOR D.O. (OWNER)
(407) 325-5227
Entity
Organization
Contact information
Practice address
10 W GROVE AVE, SUITE 108, LAKE WALES, FL 33853-4516
(407) 325-5227
Mailing address
9483 WICKHAM WAY, ORLANDO, FL 32836-5521
(407) 325-5227
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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