Provider Demographics
NPI:1518451764
Name:GILBERT, LIONEL RONTEL
Entity Type:Individual
Prefix:
First Name:LIONEL
Middle Name:RONTEL
Last Name:GILBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8074 ED LEJEUNE ST
Mailing Address - Street 2:
Mailing Address - City:ADDIS
Mailing Address - State:LA
Mailing Address - Zip Code:70710-2900
Mailing Address - Country:US
Mailing Address - Phone:225-916-5114
Mailing Address - Fax:
Practice Address - Street 1:8074 ED LEJEUNE ST
Practice Address - Street 2:
Practice Address - City:ADDIS
Practice Address - State:LA
Practice Address - Zip Code:70710-2900
Practice Address - Country:US
Practice Address - Phone:225-916-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty