Provider Demographics
NPI:1043269293
Name:GULFCOAST ORTHOPAEDIC SPECIALISTS
Entity Type:Organization
Organization Name:GULFCOAST ORTHOPAEDIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:GATES
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:239-262-1119
Mailing Address - Street 1:730 GOODLETTE RD N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5616
Mailing Address - Country:US
Mailing Address - Phone:239-262-1119
Mailing Address - Fax:239-262-2657
Practice Address - Street 1:681 GOODLETTE RD N
Practice Address - Street 2:SUITE 220
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5458
Practice Address - Country:US
Practice Address - Phone:239-263-4511
Practice Address - Fax:239-263-1963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-07
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21341OtherMEDICARE
FLCI 1573OtherRAILROAD MEDICARE
FL253254900Medicaid
FL21341BOtherMEDICARE
FL21341BMedicare PIN
FL253254900Medicaid
FL3890830002Medicare NSC
FLE2437TMedicare PIN
FL21341Medicare PIN
FL21341BOtherMEDICARE
FL3890830001Medicare NSC