Basic Information
| Provider Information | |||||||||
| NPI: | 1518958776 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOBO | ||||||||
| FirstName: | DEAN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 PINELLAS ST STE 325 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337563320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7272986121 | ||||||||
| FaxNumber: | 7272986151 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 PINELLAS ST | ||||||||
| Address2: | SUITE 325 | ||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337563312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7272986121 | ||||||||
| FaxNumber: | 7275335903 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2005 | ||||||||
| LastUpdateDate: | 04/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | ME70807 | FL | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 000705800 | 05 | FL | MEDICAID | P01024476 | 01 | FL | MEDICARE RAILROAD PROVIDER NUMBER | OTHER |