Provider Demographics
NPI:1205915014
Name:GINART, DENISE C (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:C
Last Name:GINART
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:PO BOX 45443
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84145-0443
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:3101 UNIVERSITY BLVD S STE 102
Practice Address - Street 2:CREDENTIALING DEPARTMENT
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2750
Practice Address - Country:US
Practice Address - Phone:904-737-1171
Practice Address - Fax:904-739-8022
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97036207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00643436OtherRAILROAD MEDICARE
FLAI531ZMedicare PIN
FLK1951AOtherBPC GROUP PTAN
OHH30795Medicare UPIN
FLAI531ZMedicare PIN