Gavin Douglas Divertie M.D.

NPI 1073500369 - Anesthesiology - 207L00000X

NPI Details
NPI 1073500369
Gender Male
Enumeration Date 10/01/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 12 years ago
Practice Location
4500 SAN PABLO RD S
JACKSONVILLE FL, 32224-1865, US
Phone (904) 953-2000
Fax
Business Location
4500 SAN PABLO RD S
JACKSONVILLE FL, 32224-1865, US
Phone (904) 953-2000
Fax
Toxanomy
Taxonomy Code 207L00000X
License State Florida
License Number ME54277
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According to our database, Dr. Gavin Douglas Divertie M.D. NPI is 1073500369, taxonomy code is 207L00000X and license number is ME54277, license state is located at Florida. Gavin Douglas Divertie M.D. physically located at 4500 San Pablo Rd S, Jacksonville FL, 32224-1865. NPI Number Gavin Douglas Divertie M.D. has the Individual type.

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1073500369 NPI number is provided on an as is basis without warranty of any kind. 1073500369 is maintained by the National Plan & Provider Enumeration System. The contents of Gavin Douglas Divertie M.D. are for informational purposes only.