Active NPI
Gorgette Wahib Doze I, PHYSICAL THERAPIST
- Physical Therapist
- Largo, FL
National Provider Identifier
1407311467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10632
- Practice address
- 11903 68TH St
Largo, FL 33773-3510 - Phone
- (727) 421-7038
- Fax
- (727) 587-0059
- NPI assigned
- Feb 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10632 | FL | Primary |
Addresses
Primary practice location
11903 68TH St
Largo, FL 33773-3510
Mailing address
11903 68TH St
Largo, FL 33773-3510
Phone (727) 421-7038
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FIZ376192311465 | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10632 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549238400000",
"number": "1407311467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11903 68TH ST",
"city": "LARGO",
"state": "FL",
"postal_code": "337733510",
"telephone_number": "727-421-7038",
"fax_number": "727-587-0059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11903 68TH ST",
"city": "LARGO",
"state": "FL",
"postal_code": "337733510",
"telephone_number": "727-421-7038",
"fax_number": "727-587-0059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOZE",
"first_name": "GORGETTE",
"middle_name": "WAHIB",
"name_prefix": "Mrs.",
"name_suffix": "I",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-04",
"last_updated": "2019-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "10632",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "FIZ376192311465",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.