Provider Demographics
NPI:1831216969
Name:GISBERT, CELINE R (MD)
Entity type:Individual
Prefix:
First Name:CELINE
Middle Name:R
Last Name:GISBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-416-7544
Mailing Address - Fax:850-416-7545
Practice Address - Street 1:151 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-5711
Practice Address - Country:US
Practice Address - Phone:850-416-7544
Practice Address - Fax:850-416-7545
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME116084207Q00000X, 207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021845450001Medicaid
PAP00695156OtherRAILROAD MEDICARE
PA130133Medicare PIN