Provider Demographics
NPI:1992704670
Name:GAY, DENNIS GEORGE II (PA-C)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GEORGE
Last Name:GAY
Suffix:II
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1603 S HIAWASSEE RD
Mailing Address - Street 2:ST 115
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6438
Mailing Address - Country:US
Mailing Address - Phone:407-383-0142
Mailing Address - Fax:407-386-7247
Practice Address - Street 1:1603 S HIAWASSEE RD
Practice Address - Street 2:ST 115
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6438
Practice Address - Country:US
Practice Address - Phone:407-383-0142
Practice Address - Fax:407-386-7247
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2007-10-21
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Provider Licenses
StateLicense IDTaxonomies
FLPA9102434363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU8179ZMedicare Oscar/Certification
FLQ72020Medicare UPIN