Fred S Gurtman, MD

Individual provider Active NPI Dermatology Physician · Belleair, FL

NPI 1992941975 · NPPES record last updated Jul 24, 2019

Key facts

NPI
1992941975
Entity type
Individual (NPI type 1)
Primary specialty
Dermatology Physician 207N00000X
License
ME43623 (FL)
Practice address
609 Indian Rocks Rd
Belleair, FL 33756
Phone
(855) 353-7546
Fax
(727) 315-0911
NPI assigned
Dec 23, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME43623FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Medical Clinic LLC Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME43623 FL Yes

Addresses

Primary practice location

609 Indian Rocks Rd
Belleair, FL 33756

Mailing address

1450 6TH St SE
Winter Haven, FL 33880-4505
Phone (855) 353-7546

Other providers in Belleair, FL

All providers in Belleair, FL · Dermatology Physician in Florida

Sources for this page

Verify at the official NPI Registry.