Provider Demographics
NPI:1699842302
Name:GAYLE ENTERPRISES INC
Entity type:Organization
Organization Name:GAYLE ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:407-464-9500
Mailing Address - Street 1:PO BOX 915664
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32791-5664
Mailing Address - Country:US
Mailing Address - Phone:407-788-3711
Mailing Address - Fax:407-788-3713
Practice Address - Street 1:1706 E SEMORAN BLVD
Practice Address - Street 2:SUITE 113
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5651
Practice Address - Country:US
Practice Address - Phone:407-464-9500
Practice Address - Fax:407-464-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1055332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV0445OtherBCBS
FLR3334OtherBCBS
FL0188480001Medicare NSC
FL0188480002Medicare NSC
FLV0445OtherBCBS