Provider Demographics
NPI:1457300188
Name:GITOMER, STEVEN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DAVID
Last Name:GITOMER
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 1:6516 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4022
Mailing Address - Country:US
Mailing Address - Phone:813-969-2340
Mailing Address - Fax:813-969-3877
Practice Address - Street 1:6516 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4022
Practice Address - Country:US
Practice Address - Phone:813-969-2340
Practice Address - Fax:813-969-3877
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38375207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30508YMedicare ID - Type Unspecified
FLD54022Medicare UPIN