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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JOHNNY GURGEN, D.O.

Active Sole Proprietor

JOHNNY GURGEN, D.O. is a Dermatology healthcare provider located in LADY LAKE, Florida. NPI 1962666966 is currently active in the NPPES registry. Verify at CMS.

Dermatology · LADY LAKE, FL

Registration Details

NPI Number
1962666966
Provider Type
Individual
Gender
Male
NPI Issued
Jul 18, 2008 (18.113592269229 yrs)
Last Updated
Jun 11, 2019
Licenses
OS10423 (FL)
OS10423 (FL)
Sole Proprietor
Yes

Practice Information

Address
920 ROLLING ACRES RD UNIT 203
LADY LAKE, FL, 321595029
Browse FL providers · Browse ZIP 32159
Phone
3524357695
Fax
3524357453
Primary Specialty
Dermatology
207N00000X
Additional Specialty
Dermatology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.