Provider Demographics
NPI:1427513308
Name:BARTOS, GREGORY (DO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:BARTOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SHERIDAN ST STE I
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3416
Mailing Address - Country:US
Mailing Address - Phone:954-516-0722
Mailing Address - Fax:844-639-7749
Practice Address - Street 1:4700 SHERIDAN ST STE I
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3416
Practice Address - Country:US
Practice Address - Phone:954-516-0722
Practice Address - Fax:844-639-7749
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17104207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program