Provider Demographics
NPI:1093709966
Name:GAMERO, GUSTAVO ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:ENRIQUE
Last Name:GAMERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43309 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-6221
Mailing Address - Country:US
Mailing Address - Phone:727-943-3111
Mailing Address - Fax:727-943-3334
Practice Address - Street 1:43309 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-6221
Practice Address - Country:US
Practice Address - Phone:727-943-3111
Practice Address - Fax:727-943-3334
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86438207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00110971OtherRR MEDICARE
FL2474243OtherCIGNA
FL62988OtherBCBS
FL2474243OtherCIGNA
FLG70335Medicare UPIN
FL62988OtherBCBS