Provider Demographics
NPI:1255327342
Name:GAW, JANETTE U (MD)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:U
Last Name:GAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:13770 PLANTATION RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4301
Practice Address - Country:US
Practice Address - Phone:239-275-0728
Practice Address - Fax:239-275-6947
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0093273208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07476OtherUNIV. HLTHCR. PROVIDER #
FL7585707OtherAETNA OTHER PROVIDER #
FLME93273OtherMETCARE PROVIDER NUMBER
FL17-02964OtherUHC PROVIDER NUMBER
FLP00313874OtherRAILROAD MEDICARE #
FL16080OtherBCBS PROVIDER NUMBER
FL272745500Medicaid
FL7618345-001OtherCIGNA PROVIDER NUMBER
FL1230905OtherWELLCARE
FL17-02964OtherUHC PROVIDER NUMBER
FL16080OtherBCBS PROVIDER NUMBER