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:
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Health care specialties

SpecialtyCodeLicense #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 2 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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