Provider Demographics
NPI:1790771723
Name:GIDEL, LOUIS T (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:T
Last Name:GIDEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3625 NW 82ND AVE
Mailing Address - Street 2:SUITE 408
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6652
Mailing Address - Country:US
Mailing Address - Phone:305-436-9933
Mailing Address - Fax:305-436-9944
Practice Address - Street 1:7000 SW 62ND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4716
Practice Address - Country:US
Practice Address - Phone:305-661-8225
Practice Address - Fax:305-661-1510
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2015-05-08
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Provider Licenses
StateLicense IDTaxonomies
FLME50977207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058298100Medicaid
FL058298100Medicaid
FLD21194Medicare UPIN