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Individual

GARY A GOFORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13880 SHELL POINT PLAZA, SUITE 110, FORT MYERS, FL 33908-3504
(239) 466-1111
(239) 454-2111
Mailing address
15000 SHELL POINT BLVD STE 100, FORT MYERS, FL 33908-1657
(239) 433-7937

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME131713
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006438400
FL
Enumeration date
07/16/2006
Last updated
05/09/2022
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