Provider Demographics
NPI:1619231594
Name:IMBARRATO, GREGORY JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JAMES
Last Name:IMBARRATO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:800 PRUDENTIAL DR FL B11
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8202
Mailing Address - Country:US
Mailing Address - Phone:904-388-6518
Mailing Address - Fax:904-384-1005
Practice Address - Street 1:330 BILLINGSLEY RD STE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-5020
Practice Address - Country:US
Practice Address - Phone:704-316-3070
Practice Address - Fax:704-316-3071
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2020-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125061753207T00000X
FLOS14995207T00000X
NC2019-00971207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery