Provider Demographics
NPI:1780117119
Name:DICHIARA, GERARD JOSEPH JR (DO)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:JOSEPH
Last Name:DICHIARA
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4129 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6436
Mailing Address - Country:US
Mailing Address - Phone:813-879-3699
Mailing Address - Fax:
Practice Address - Street 1:4129 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6436
Practice Address - Country:US
Practice Address - Phone:813-879-3699
Practice Address - Fax:813-873-8469
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19557207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine