Gateway Surgical Group LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

GATEWAY SURGICAL GROUP LLC

Practice address

3140 NW Medical Center LN
Suite 120
Lake City, FL 32055-4717

Phone

(386) 755-6682

Fax

(386) 755-6796

NPI assigned

Jun 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mickey Pickler

Title

VP

Phone

(386) 755-6682

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edwin Gonzalez-Navedo, MD

  • Surgery Physician
  • Lake City, FL
  • NPI 1710971460
  NPD (past)
• Alejandro T Soler, MD

  • Surgery Physician
  • Lake City, FL
  • NPI 1205821683
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1104868413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 NW MEDICAL CENTER LN",
            "address_2": "SUITE 120",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554717",
            "telephone_number": "386-755-6682",
            "fax_number": "386-755-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 NW MEDICAL CENTER LN",
            "address_2": "SUITE 120",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554717",
            "telephone_number": "386-755-6682",
            "fax_number": "386-755-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY SURGICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "386-755-6682"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "94830",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cornelius Tyrell Gaskin, REGISTERED NURSE
• Gateway Prescription Center Inc
• Gateway Prescription Center Inc
• Gateway Prescription Center, Inc
• Gateway Prescription Center, Inc
• Gateway Therapy Services LLC
• Luis Gaviria, LCSW
• Natalya V Gaydarzhi, LICSW
• GC Therapy Lake City, Inc
• Lacey Dawn Geiger, AGACNP

• Surgery Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.