Provider Demographics
NPI:1174269294
Name:FRENCH, GAVIN (MD)
Entity Type:Individual
Prefix:
First Name:GAVIN
Middle Name:
Last Name:FRENCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 NE 21ST LN
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1040
Mailing Address - Country:US
Mailing Address - Phone:954-648-0110
Mailing Address - Fax:
Practice Address - Street 1:2626 CAPITOL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32399-6581
Practice Address - Country:US
Practice Address - Phone:850-325-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program