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Organization

HILLMOOR ER SVCS PARTNERSHIP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH GATEWOOD (PRESIDENT)
(214) 712-2000
Entity
Organization

Contact information

Practice address
1800 SE TIFFANY AVE, PORT ST LUCIE, FL 34952-7521
(772) 398-3800
(772) 398-3714
Mailing address
PO BOX 41585, PHILADELPHIA, PA 19101-1585

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
72363
BLUE SHIELD
FL
Enumeration date
05/08/2006
Last updated
04/20/2008
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