Provider Demographics
NPI:1639143399
Name:GILMORE, ERNEST EDWARD III (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:EDWARD
Last Name:GILMORE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2250 OSPREY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-4340
Mailing Address - Country:US
Mailing Address - Phone:863-533-1448
Mailing Address - Fax:863-533-2189
Practice Address - Street 1:2250 OSPREY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-4340
Practice Address - Country:US
Practice Address - Phone:863-533-1448
Practice Address - Fax:863-533-2189
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 0065000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine