Provider Demographics
NPI:1689816316
Name:GERIATRICS AND INTERNAL MEDICINE PRACTICES PA
Entity Type:Organization
Organization Name:GERIATRICS AND INTERNAL MEDICINE PRACTICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-367-9700
Mailing Address - Street 1:PO BOX 141045
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-1045
Mailing Address - Country:US
Mailing Address - Phone:352-367-9700
Mailing Address - Fax:352-367-1009
Practice Address - Street 1:3921 SW 34TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-6560
Practice Address - Country:US
Practice Address - Phone:352-336-3050
Practice Address - Fax:352-337-2571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83771207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022ZJOtherBC FLORIDA
FLCM018AMedicare PIN