Individual
JOHNNY GURGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
920 ROLLING ACRES RD UNIT 203, LADY LAKE, FL 32159-5029
(352) 435-7695
(352) 435-7453
Mailing address
920 ROLLING ACRES RD UNIT 203, LADY LAKE, FL 32159-5029
(352) 435-7695
(352) 435-7453
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS10423
FL
207ND0101X
MOHS-Micrographic Surgery Physician
OS10423
FL
Other
Enumeration date
07/18/2008
Last updated
06/11/2019
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