Provider Demographics
NPI:1891819827
Name:GILMER, ALBIN MCCULLA (PT)
Entity Type:Individual
Prefix:MR
First Name:ALBIN
Middle Name:MCCULLA
Last Name:GILMER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6330 SUMMER LAKES CT
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4675
Mailing Address - Country:US
Mailing Address - Phone:850-698-4530
Mailing Address - Fax:
Practice Address - Street 1:1040 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4838
Practice Address - Country:US
Practice Address - Phone:850-934-2180
Practice Address - Fax:850-934-4181
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 215042251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic