Provider Demographics
NPI:1700847597
Name:GIL, RAMON A (MD)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:A
Last Name:GIL
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 1:4235 KINGS HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-8421
Mailing Address - Country:US
Mailing Address - Phone:941-743-4987
Mailing Address - Fax:941-743-4486
Practice Address - Street 1:4235 KINGS HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-8421
Practice Address - Country:US
Practice Address - Phone:941-743-4987
Practice Address - Fax:941-743-4486
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56096174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME56096OtherMEDICAL LICENSE
FL061402500Medicaid
FL061402500Medicaid
FLE66563Medicare UPIN