Provider Demographics
NPI:1700151081
Name:GILBERT, EDWARD ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ANDREW
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 OFFICE PARK PL
Mailing Address - Street 2:400
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8239
Mailing Address - Country:US
Mailing Address - Phone:321-751-2333
Mailing Address - Fax:321-751-1733
Practice Address - Street 1:1070 S WICKHAM RD
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1653
Practice Address - Country:US
Practice Address - Phone:321-751-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor