Provider Demographics
NPI:1144378514
Name:GOROSPE, CESAR A (ND)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:A
Last Name:GOROSPE
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7240 SAN PEDRO RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-3408
Mailing Address - Country:US
Mailing Address - Phone:904-731-5107
Mailing Address - Fax:
Practice Address - Street 1:7240 SAN PEDRO RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-3408
Practice Address - Country:US
Practice Address - Phone:904-731-5107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0023609207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD53078Medicare UPIN