Provider Demographics
NPI:1629110051
Name:SHEILA GILLIKIN MD PA
Entity Type:Organization
Organization Name:SHEILA GILLIKIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-326-5402
Mailing Address - Street 1:7750 E MISTY LN
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-3550
Mailing Address - Country:US
Mailing Address - Phone:352-326-5254
Mailing Address - Fax:
Practice Address - Street 1:1014 E NORTH BLVD
Practice Address - Street 2:HWY 441
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5348
Practice Address - Country:US
Practice Address - Phone:352-326-5254
Practice Address - Fax:352-326-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7947Medicare ID - Type Unspecified