Provider Demographics
NPI:1558338343
Name:CU, GIL A (MD)
Entity Type:Individual
Prefix:
First Name:GIL
Middle Name:A
Last Name:CU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10150 BELLE RIVE BLVD UNIT 602
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9589
Mailing Address - Country:US
Mailing Address - Phone:904-228-7239
Mailing Address - Fax:800-747-3061
Practice Address - Street 1:10150 BELLE RIVE BLVD UNIT 602
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9589
Practice Address - Country:US
Practice Address - Phone:904-228-7239
Practice Address - Fax:800-747-3061
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME69707207R00000X, 207RN0300X
FLME-0069707207RN0300X
HIMD-19089207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI003983Medicaid
GA00770976AMedicaid
GA00770976AMedicaid
GAF71695Medicare UPIN
GA11BDNBPMedicare PIN
FLP00000472Medicare PIN