Provider Demographics
NPI:1225465800
Name:DANA LYNN GILES MD PA
Entity Type:Organization
Organization Name:DANA LYNN GILES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-201-0730
Mailing Address - Street 1:PO BOX 490507
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-0507
Mailing Address - Country:US
Mailing Address - Phone:407-201-0730
Mailing Address - Fax:
Practice Address - Street 1:5050 COUNTY ROAD 472
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:FL
Practice Address - Zip Code:34484-3750
Practice Address - Country:US
Practice Address - Phone:407-201-0730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 114553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty