Provider Demographics
NPI:1780670083
Name:GILBERSTADT, FRANK H (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:H
Last Name:GILBERSTADT
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:PO BOX 863026
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3026
Mailing Address - Country:US
Mailing Address - Phone:800-288-8325
Mailing Address - Fax:419-866-5453
Practice Address - Street 1:1 SHIRCLIFF WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4748
Practice Address - Country:US
Practice Address - Phone:904-308-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2013-01-28
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-07-31
Provider Licenses
StateLicense IDTaxonomies
FLME0066172207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376027800Medicaid
FL25736OtherBCBS
930022841OtherRAILROAD MEDICARE
FL25736OtherBCBS
FL25736ZMedicare PIN