Provider Demographics
NPI:1710115647
Name:ZIEL, GILBERT ELLIS (MD)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:ELLIS
Last Name:ZIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ELLIS
Other - Middle Name:
Other - Last Name:ZIEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1245 SPANISH LACE LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2394
Mailing Address - Country:US
Mailing Address - Phone:312-608-8766
Mailing Address - Fax:
Practice Address - Street 1:3555 10TH CT STE 101
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5013
Practice Address - Country:US
Practice Address - Phone:772-567-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1309802085R0001X
IL125.0585382085R0001X
WAMD605482752085R0001X
GA874232085R0001X
FLME1657782085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology