Provider Demographics
NPI:1194233262
Name:GAVOCI, CEZERINA
Entity type:Individual
Prefix:MISS
First Name:CEZERINA
Middle Name:
Last Name:GAVOCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 JOHNNY MERCER BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2118
Mailing Address - Country:US
Mailing Address - Phone:912-897-8106
Mailing Address - Fax:
Practice Address - Street 1:155 JOHNNY MERCER BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31410-2118
Practice Address - Country:US
Practice Address - Phone:912-897-8106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program