Provider Demographics
NPI:1447485982
Name:GREGORY GULICK DO PA
Entity type:Organization
Organization Name:GREGORY GULICK DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:GULICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-642-6221
Mailing Address - Street 1:2575 ULMERTON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-2283
Mailing Address - Country:US
Mailing Address - Phone:727-642-6221
Mailing Address - Fax:
Practice Address - Street 1:2575 ULMERTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-2283
Practice Address - Country:US
Practice Address - Phone:727-642-6221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9699207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty