Organization Name: | GTP MANAGEMENT INC |
NPI Number: | 1184677288 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GEORGE S PETRYK (PRESIDENT) |
Mailing Address: | 8801 College Pkwy Suite 2 Ft Myers |
State: | FL US |
Postal Code: | 339194882 |
Phone Number: | 2394820300 |
Fax Number: | 2394824757 |
NPI Enumeration Date: | 05/18/2006 |
NPI Last Update Date: | 06/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS7123 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |