Provider Demographics
NPI:1073529889
Name:GILL, PARMJIT KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:PARMJIT
Middle Name:KAUR
Last Name:GILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LAKE REGION CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-9549
Mailing Address - Country:US
Mailing Address - Phone:863-446-1698
Mailing Address - Fax:863-644-9354
Practice Address - Street 1:4304 HIGHLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1647
Practice Address - Country:US
Practice Address - Phone:863-644-9398
Practice Address - Fax:863-644-9354
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96413208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276229300Medicaid
FL56300OtherBLUE CROSS BLUE SHIELD OF FLORIDA
FLME96413OtherMEDICAL DOCTOR LICENCE