Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | AP 751 | FL |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | AP 751 | FL |
Y | 111N00000X | Chiropractor | DC002674L | PA |
N | 111NN1001X | Nutrition | DC002674L | PA |
N | 111NR0400X | Rehabilitation Chiropractor | DC002674L | PA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC002674L | PA |
N | 175F00000X | Naturopath | AP 751 | FL |
N | 175L00000X | Homeopath | AP 751 | FL |
N | 225400000X | Rehabilitation Practitioner | AP 751 | FL |
N | 225700000X | Massage Therapist | AP 751 | FL |
NPI | 1710021654 |
---|---|
Provider Name | Dr. Jean A Gormley |
First Address | Cudjoe Key, FL 33042-4061 |
Second Address | Cudjoe Key, FL 33042-4061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 31/08/2021 |