Provider Demographics
NPI:1750347753
Name:GHEILER, EDWARD L (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:L
Last Name:GHEILER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:2140 W 68TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-822-7227
Practice Address - Fax:305-827-6333
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME74630208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4133112OtherCIGNA
FLP942070OtherOPTIMUM
FL7142033OtherAETNA
FLP01718270OtherSIMPLY
FL1251374OtherWELLCARE
FL258481OtherAVMED
FLP985853OtherFREEDOM
FLP01601019OtherRR MEDICARE
FL46615OtherBCBS
FLP01601019OtherRR MEDICARE
FL46615YMedicare PIN