Provider Demographics
NPI:1255440384
Name:GAYLIS, NORMAN B (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:B
Last Name:GAYLIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2801 NE 213TH ST STE 801
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1264
Mailing Address - Country:US
Mailing Address - Phone:305-652-6676
Mailing Address - Fax:305-932-6335
Practice Address - Street 1:2801 NE 213TH ST STE 801
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1264
Practice Address - Country:US
Practice Address - Phone:305-652-6676
Practice Address - Fax:305-932-6335
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME31090207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062234600Medicaid
FL95375Medicare PIN
FL95375WMedicare Oscar/Certification
FL062234600Medicaid