Provider Demographics
NPI:1558414706
Name:GERNIER, EUGENE (PA)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:GERNIER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-2725
Mailing Address - Country:US
Mailing Address - Phone:352-629-3455
Mailing Address - Fax:352-629-8642
Practice Address - Street 1:9500 SATELLITE BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8464
Practice Address - Country:US
Practice Address - Phone:407-859-5656
Practice Address - Fax:407-859-2124
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103150363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant