Provider Demographics
NPI:1124323860
Name:RAPTOULIS, GINA (DO)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:RAPTOULIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32615 US 19 N
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3176
Mailing Address - Country:US
Mailing Address - Phone:727-789-2784
Mailing Address - Fax:727-785-3537
Practice Address - Street 1:32615 US 19 N
Practice Address - Street 2:SUITE 2
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3176
Practice Address - Country:US
Practice Address - Phone:727-789-2784
Practice Address - Fax:727-785-3537
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS11500207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology