Divertie, Gavin Douglas
Divertie, Gavin Douglas is an individual health care provider with primary practice located at 4500 San Pablo Rd S , Jacksonville FL 32224-1865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Critical Care Medicine, which is considered as his primary health care specialty. Divertie, Gavin Douglas can be contacted via phone (904) 953-2000.Contact Information
Primary practice address
4500 San Pablo Rd S
Jacksonville FL 32224-1865
Phone: (904) 953-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | ME54277 | Florida |
Profile Details
| NPI number | 1073500369 |
|---|---|
| LBN Legal business name | Divertie, Gavin Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 1st, 2005 |
| Last updated | Sep 25th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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