Provider Demographics
NPI:1821125642
Name:LINCOLN, GAIL D (OD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:D
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:12554 S JOHN YOUNG PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4004
Mailing Address - Country:US
Mailing Address - Phone:407-850-0050
Mailing Address - Fax:407-850-0010
Practice Address - Street 1:12554 S JOHN YOUNG PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-4004
Practice Address - Country:US
Practice Address - Phone:407-850-0050
Practice Address - Fax:407-850-0010
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOPC2145152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU40713Medicare UPIN