Provider Demographics
NPI:1568791457
Name:GILBERT, MARLON DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLON
Middle Name:DAVID
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 BAY RD
Mailing Address - Street 2:APT 1119
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3268
Mailing Address - Country:US
Mailing Address - Phone:305-588-2314
Mailing Address - Fax:
Practice Address - Street 1:4430 SHERIDAN ST
Practice Address - Street 2:SUITE A
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3546
Practice Address - Country:US
Practice Address - Phone:954-962-2309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL105627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine