Provider Demographics
NPI:1659476794
Name:GAGE, JEFFREY ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ANDREW
Last Name:GAGE
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 1:2700 UNIVERSITY SQUARE DR
Mailing Address - Street 2:RADIOLOGY ASSOC OF TAMPA
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5513
Mailing Address - Country:US
Mailing Address - Phone:813-251-5822
Mailing Address - Fax:
Practice Address - Street 1:2700 UNIVERSITY SQUARE DRIVE
Practice Address - Street 2:RADIOLOGY ASSOCIATES OF TAMPA
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5513
Practice Address - Country:US
Practice Address - Phone:813-251-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-000822085R0202X
FLME862052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00469020OtherRR MEDICARE
FL277158600Medicaid
FLP00428416OtherRR MEDICARE
FLP00470551OtherRR MEDICARE
FLP00470551OtherRR MEDICARE
FLP00470551OtherRR MEDICARE
FLAF656ZMedicare PIN
FLAF656YMedicare PIN
FLP00428416OtherRR MEDICARE
FLAF656WMedicare PIN
FLAF656Medicare PIN