Provider Demographics
NPI:1811016058
Name:GORSKI, PETER A (MD, MPA)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:GORSKI
Suffix:
Gender:M
Credentials:MD, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 ROYAL PASS RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5724
Mailing Address - Country:US
Mailing Address - Phone:813-204-1701
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S BOARD OF HILLSBOROUGH COUNTY
Practice Address - Street 2:1002 E. PALM AVE
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605
Practice Address - Country:US
Practice Address - Phone:813-204-1701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38842208000000X
FLME 892192080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics