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:
Health care specialties
| Specialty | Code | License # | 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 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235117102 | NPPES |
| Georgia | Other | 08CBCLW | MEDICARE |
| Georgia | MEDICAID | 489023752B | MEDICARE |
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