Provider Demographics
NPI:1942273792
Name:SAINT AMAND, GERARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:J
Last Name:SAINT AMAND
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:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34106-0429
Mailing Address - Country:US
Mailing Address - Phone:239-774-8200
Mailing Address - Fax:239-774-5653
Practice Address - Street 1:3301 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-3969
Practice Address - Country:US
Practice Address - Phone:239-774-5653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16033OtherBLUE CROSS BLUE SHIELD
C07405Medicare UPIN
FL16330ZMedicare ID - Type UnspecifiedMEDICARE INDIV ID