Provider Demographics
NPI:1003055203
Name:NORMAN B. GAYLIS M.D. PA
Entity Type:Organization
Organization Name:NORMAN B. GAYLIS M.D. PA
Other - Org Name:ARTHRITIS & RHEUMATIC DISEASE SPECIALTIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GAYLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-652-6676
Mailing Address - Street 1:2801 NE 213TH ST STE 801
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1264
Mailing Address - Country:US
Mailing Address - Phone:305-652-6676
Mailing Address - Fax:305-932-6335
Practice Address - Street 1:2801 NE 213TH ST STE 801
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1264
Practice Address - Country:US
Practice Address - Phone:305-652-6676
Practice Address - Fax:305-932-6335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME3190207RR0500X
207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCT800AMedicare PIN