Provider Demographics
NPI:1255439865
Name:GILROY, PATRICIA A (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:GILROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 9TH AVE N
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6800
Mailing Address - Country:US
Mailing Address - Phone:727-321-3344
Mailing Address - Fax:727-323-7414
Practice Address - Street 1:2299 9TH AVE N
Practice Address - Street 2:SUITE 3B
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6800
Practice Address - Country:US
Practice Address - Phone:727-321-3344
Practice Address - Fax:727-323-7414
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90004207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43289ZOtherMEDICARE ID
FL269742400Medicaid
FL269742400Medicaid