Provider Demographics
NPI:1831087345
Name:GILBERT, JULIAN TAKUMA (OD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:TAKUMA
Last Name:GILBERT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3091 WOLFE CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-5068
Mailing Address - Country:US
Mailing Address - Phone:407-792-8204
Mailing Address - Fax:
Practice Address - Street 1:11422 US 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-6170
Practice Address - Country:US
Practice Address - Phone:813-402-2743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6698152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist