Provider Demographics
NPI:1548284243
Name:GOTSIS, PERRY A (MD)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:A
Last Name:GOTSIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:680 2ND AVE N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5753
Mailing Address - Country:US
Mailing Address - Phone:239-263-8800
Mailing Address - Fax:239-263-8300
Practice Address - Street 1:680 2ND AVE N
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5753
Practice Address - Country:US
Practice Address - Phone:239-263-8800
Practice Address - Fax:239-263-8300
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME38175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA66889Medicare UPIN