Provider Demographics
NPI:1700847431
Name:SHUTE, GERALD CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:CHARLES
Last Name:SHUTE
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 1:7710 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-2320
Mailing Address - Country:US
Mailing Address - Phone:772-335-5300
Mailing Address - Fax:772-878-7602
Practice Address - Street 1:7710 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-2320
Practice Address - Country:US
Practice Address - Phone:772-335-5300
Practice Address - Fax:772-878-7602
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92898207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6862227OtherCIGNA
FL7763216OtherAETNA
FLP00262483OtherRR MCR
FL03514OtherBCBS
FLP00262483OtherRR MCR
FL03514OtherBCBS
FLP00262483Medicare PIN
FLH30253Medicare UPIN