Provider Demographics
NPI:1467476176
Name:PERRY A GOTSIS MD P.A
Entity Type:Organization
Organization Name:PERRY A GOTSIS MD P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOTSIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-263-8800
Mailing Address - Street 1:680 2ND AVE N
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5753
Mailing Address - Country:US
Mailing Address - Phone:239-263-8800
Mailing Address - Fax:239-263-8300
Practice Address - Street 1:680 2ND AVE N
Practice Address - Street 2:SUITE 2
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5753
Practice Address - Country:US
Practice Address - Phone:239-263-8800
Practice Address - Fax:239-263-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA66889Medicare UPIN