Healthcare Provider Details

I. General information

NPI: 1578629762
Provider Name (Legal Business Name): RONALD K GILBERT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 60TH ST W STE B
BRADENTON FL
34209-5526
US

IV. Provider business mailing address

2109 60TH ST W STE B
BRADENTON FL
34209-5526
US

V. Phone/Fax

Practice location:
  • Phone: 941-794-3344
  • Fax:
Mailing address:
  • Phone: 941-794-3344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH7101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: