Provider Demographics
NPI:1174516546
Name:GURSOY, AHMET SINAN (MD)
Entity type:Individual
Prefix:DR
First Name:AHMET
Middle Name:SINAN
Last Name:GURSOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26002
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33623-6002
Mailing Address - Country:US
Mailing Address - Phone:239-643-9977
Mailing Address - Fax:239-643-3424
Practice Address - Street 1:6609 WILLOW PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-9015
Practice Address - Country:US
Practice Address - Phone:239-643-9977
Practice Address - Fax:239-596-3743
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68469207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00205816OtherMEDICARE RR
FL378223900Medicaid
FL27546OtherBCBS
FL201095753OtherTAX ID
FLP00205816OtherMEDICARE RR
FL201095753OtherTAX ID