Gulf Coast Retina Associates, LLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

ME68907 Issued in FL

Legal business name

GULF COAST RETINA ASSOCIATES, LLC

Practice address

2055 Little Rd
Trinity, FL 34655

Phone

(727) 862-3090

Fax

(727) 862-3023

NPI assigned

Feb 7, 2007

Last updated

Nov 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Doug Davis

Title

Office Manager

Phone

(727) 862-3090

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541116800000",
    "number": "1780724112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554421",
            "telephone_number": "727-862-3090",
            "fax_number": "727-862-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "34655",
            "telephone_number": "727-862-3090",
            "fax_number": "727-862-3023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10730 US Highway 19 Ste 7",
            "address_purpose": "LOCATION",
            "city": "Port Richey",
            "state": "FL",
            "postal_code": "346682863",
            "country_code": "US",
            "telephone_number": "727-862-3090",
            "fax_number": "727-862-3023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GULF COAST RETINA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2018-11-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "727-862-3090",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME68907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379522500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Growth and Recovery Center
• Adam Jacob Grunbaum, DO, FACOI, FACR
• Steven Gryn
• Marina Magdy Guirguis
• Gulf Coast Kidney Center Inc (Physicians Dialysis Trinity)
• Gulf Coast Rheumatology, PLLC
• Gulf Coast Surgical Group, LLC
• Kabir Singh Gumer
• Shannon Christie Gummoe, APRN
• Alana Gunderson, FNP-C

• Retina Specialist (Ophthalmology) Physician in Trinity, FL
• Providers in Trinity, FL by specialty
• Retina Specialist (Ophthalmology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.