Provider Demographics
NPI:1386830479
Name:GAMEZ, ARTURO (MD)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:GAMEZ
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 1:2115 SE LENNARD RD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-4742
Mailing Address - Country:US
Mailing Address - Phone:772-335-1812
Mailing Address - Fax:772-335-1825
Practice Address - Street 1:2115 SE LENNARD RD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-4742
Practice Address - Country:US
Practice Address - Phone:772-335-1812
Practice Address - Fax:772-335-1825
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 104786208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105013000Medicaid