Provider Demographics
NPI:1184906679
Name:SAMITIER, GONZALO (MD)
Entity type:Individual
Prefix:
First Name:GONZALO
Middle Name:
Last Name:SAMITIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GONZALO
Other - Middle Name:
Other - Last Name:SOLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:BOX 100371
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0371
Mailing Address - Country:US
Mailing Address - Phone:352-273-7375
Mailing Address - Fax:352-273-7388
Practice Address - Street 1:3450 HULL RD
Practice Address - Street 2:3RD FLOOR, RM 3341
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4144
Practice Address - Country:US
Practice Address - Phone:352-273-7375
Practice Address - Fax:352-273-7388
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN15765390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program