Individual
GREGORY LOGSDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 200-2355
Mailing address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 200-2355
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
ME61587
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME61587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14887
BCBS OF FLORIDA
FL
01
—
300032799
RR MEDICARE
FL
05
—
370023200
—
FL
Enumeration date
07/06/2005
Last updated
01/31/2020
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