Provider Demographics
NPI:1013332865
Name:GIL GARCIA, NELSON HOMERO (MD)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:HOMERO
Last Name:GIL GARCIA
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 1:6675 WESTWOOD BLVD STE 475
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6027
Mailing Address - Country:US
Mailing Address - Phone:407-845-0330
Mailing Address - Fax:888-972-1752
Practice Address - Street 1:111 WEBB DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3962
Practice Address - Country:US
Practice Address - Phone:863-421-9447
Practice Address - Fax:863-421-1806
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18620146D00000X
FLACN1409208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant