Provider Demographics
NPI:1346415577
Name:GIBSON, JANE S (PHD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:S
Last Name:GIBSON
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4204
Mailing Address - Country:US
Mailing Address - Phone:800-330-6565
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:8150 CHANCELLOR DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7691
Practice Address - Country:US
Practice Address - Phone:407-587-4243
Practice Address - Fax:407-251-5053
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
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Provider Licenses
StateLicense IDTaxonomies
FLD130551207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics