Provider Demographics
NPI:1366482598
Name:GIL, ELSA VICTORIA (MD)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:VICTORIA
Last Name:GIL
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 1:20818 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1147
Mailing Address - Country:US
Mailing Address - Phone:786-520-3382
Mailing Address - Fax:786-513-2203
Practice Address - Street 1:20818 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1147
Practice Address - Country:US
Practice Address - Phone:786-520-3382
Practice Address - Fax:786-513-2203
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA073496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ209136OtherMEDICARE
NJH62110Medicare UPIN