Gibbons, Richard B

Gibbons, Richard B is an individual health care provider with primary practice located at 1859 Sw Newland Way , Lake City FL 32025-6966. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Gibbons, Richard B can be contacted via phone (386) 758-0003.

Contact Information

Primary practice address
1859 Sw Newland Way Lake City FL 32025-6966
Phone: (386) 758-0003
Fax: (386) 755-7940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP1144982 Florida

Profile Details

NPI number 1346207586
LBN Legal business name Gibbons, Richard B
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Nov 10th, 2014 - about 12 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 1346207586 NPPES
Florida MEDICAID 307264900

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