Individual
GEORGE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10500 UNIVERSITY CENTER DR, STE 175, TAMPA, FL 33612-6494
(800) 929-6694
(407) 856-2312
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(214) 932-8029
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
ME94720
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
C1-0007055
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274275600
—
FL
Enumeration date
12/01/2005
Last updated
05/08/2015
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