Provider Demographics
NPI:1457553562
Name:GAITAN, LUCIA FERNANDA (MD)
Entity type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:FERNANDA
Last Name:GAITAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8950 SW 74TH CT
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3171
Mailing Address - Country:US
Mailing Address - Phone:305-661-7766
Mailing Address - Fax:306-661-0329
Practice Address - Street 1:8950 SW 74TH CT
Practice Address - Street 2:SUITE 2001
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3171
Practice Address - Country:US
Practice Address - Phone:305-661-7766
Practice Address - Fax:306-661-0329
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2016-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 100821207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002258700Medicaid
FL002258700Medicaid