Provider Demographics
NPI:1447420583
Name:DANIEL GILL, MD, PL
Entity Type:Organization
Organization Name:DANIEL GILL, MD, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-538-4047
Mailing Address - Street 1:PO BOX 781299
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32978-1299
Mailing Address - Country:US
Mailing Address - Phone:772-581-6226
Mailing Address - Fax:
Practice Address - Street 1:5900 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4342
Practice Address - Country:US
Practice Address - Phone:772-581-6226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45264Medicare PIN