Gaines, Carol M

Gaines, Carol M is an individual health care provider with primary practice located at 5535 S. Williamson Blvd Suite 700, Port Orange FL 32128-8311. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gaines, Carol M can be contacted via phone (386) 231-6300.

Contact Information

Primary practice address
5535 S. Williamson Blvd Suite 700 Port Orange FL 32128-8311
Phone: (386) 231-6300
Fax: (386) 322-6165
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS10126 Florida

Profile Details

NPI number 1235117102
LBN Legal business name Gaines, Carol M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2006
Last updated Jan 4th, 2017 - about 9 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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Identifiers

StateTypeNumberIssuer
All States NPI 1235117102 NPPES
Georgia Other 08CBCLW MEDICARE
Georgia MEDICAID 489023752B MEDICARE

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