Provider Demographics
NPI:1326201146
Name:GILL, ROOP MONICA (BM MD)
Entity Type:Individual
Prefix:DR
First Name:ROOP
Middle Name:MONICA
Last Name:GILL
Suffix:
Gender:F
Credentials:BM MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 N FLAGLER DR STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6555
Mailing Address - Country:US
Mailing Address - Phone:561-388-9571
Mailing Address - Fax:561-560-8331
Practice Address - Street 1:1717 N FLAGLER DR STE 1
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6555
Practice Address - Country:US
Practice Address - Phone:561-388-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110466208200000X
PAMT186534390200000X
FLME140284208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program