Provider Demographics
NPI:1982744165
Name:GAINEY, PEGGY ANNE (MD)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:ANNE
Last Name:GAINEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ANNE
Other - Last Name:GAINEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:PLACIDA
Mailing Address - State:FL
Mailing Address - Zip Code:33946
Mailing Address - Country:US
Mailing Address - Phone:941-258-6755
Mailing Address - Fax:941-475-2955
Practice Address - Street 1:1861 PLACIDA RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223
Practice Address - Country:US
Practice Address - Phone:941-258-6755
Practice Address - Fax:941-475-2955
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2023-01-31
Deactivation Date:2010-02-17
Deactivation Code:
Reactivation Date:2013-05-22
Provider Licenses
StateLicense IDTaxonomies
FLME598342083A0300X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine