GBT Lba

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

208VP0014X Issued in FL

Legal business name

GBT LBA

Practice address

3101 University Blvd S
Suite 203
Jacksonville, FL 32216-2790

Phone

(904) 518-9654

Fax

(904) 724-5770

NPI assigned

Dec 3, 2014

Organization subpart

No

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

Authorized official

Name

Mr. James Coker

Title

President

Phone

(904) 518-9654

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1710384979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2895 EGRET CT",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872369",
            "telephone_number": "904-518-9654",
            "fax_number": "904-724-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 UNIVERSITY BLVD S",
            "address_2": "SUITE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162790",
            "telephone_number": "904-518-9654",
            "fax_number": "904-724-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GBT LBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "COKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-518-9654",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "FL",
            "license": "208VP0014X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1427002799",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Gaynor
• Victoria K. Gazarova, BCABA
• Amila Gazibara, NP
• Esther Gborie
• GBT Lab Inc
• Gdmjax LLC
• Ashley Davis Gearen
• Geaux Major Health LLC
• Caitlyn Gebhard, PT, DPT
• William Gebhard, OD

• Pain Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pain Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.