Provider Demographics
NPI:1932300068
Name:GREGORITCH, JANE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:MARIE
Last Name:GREGORITCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10111 SW 67TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-6379
Mailing Address - Country:US
Mailing Address - Phone:352-371-2222
Mailing Address - Fax:
Practice Address - Street 1:10111 SW 67TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-6379
Practice Address - Country:US
Practice Address - Phone:352-371-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19512207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL19512OtherSTATE MEDICAL LICENSE NUM