Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME141702 | FL |
N | 207R00000X | Internist | ME141702 | FL |
N | 111NI0900X | Internist | ME141702 | FL |
N | 208000000X | Pediatrician | ME141702 | FL |
N | 2080P0201X | Pediatric Allergist | ME141702 | FL |
NPI | 1609259456 |
---|---|
Provider Name | David Gubernick |
First Address | Largo, FL 33773-1812 |
Second Address | Largo, FL 33773-1812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2015 |
Last Update Date | 29/06/2021 |