| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JAKE GIFFORD | 1922675321 | 2021-06-06 |
Jake Gifford is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1922675321. Registration indicates Jake Gifford is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Jake Gifford |
| Practice Office Address | 205 SE 16TH AVE APT 24D GAINESVILLE, FL US |
| Practice Office Telephone | 8592859374 |
| Mailing Address | 1600 SW ARCHER RD BOX 100286 GAINESVILLE, FL 32610 US |
| Business Telephone | 3522650761 |
| Business Fax | 3522651060 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | PA9114703
FL |
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |