Provider Demographics
NPI:1366548760
Name:ABOUD, GEHAD ANTHONY (DO)
Entity type:Individual
Prefix:
First Name:GEHAD
Middle Name:ANTHONY
Last Name:ABOUD
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 1:501 S. LINCOLN AVE.
Mailing Address - Street 2:STE#15
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756
Mailing Address - Country:US
Mailing Address - Phone:727-446-6760
Mailing Address - Fax:727-441-2465
Practice Address - Street 1:501 S. LINCOLN AVE.
Practice Address - Street 2:STE#15
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756
Practice Address - Country:US
Practice Address - Phone:727-446-6760
Practice Address - Fax:727-441-2465
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS79102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF95019Medicare UPIN