Provider Demographics
NPI:1265448278
Name:GIL, GILBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:
Last Name:GIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CALLE MARINA
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783
Mailing Address - Country:US
Mailing Address - Phone:787-859-1062
Mailing Address - Fax:787-859-2596
Practice Address - Street 1:6 CALLE MARINA
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-859-1062
Practice Address - Fax:787-859-2596
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10052174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10052OtherLOCAL LICENSE
PR10052OtherLOCAL LICENSE
PRF18918Medicare UPIN