Healthcare Provider Details

I. General information

NPI: 1336137819
Provider Name (Legal Business Name): JENNIFER R GILBY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 S SUNCOAST BLVD
HOMOSASSA FL
34448-2322
US

IV. Provider business mailing address

751 34TH AVE NE
ST PETERSBURG FL
33704-2336
US

V. Phone/Fax

Practice location:
  • Phone: 352-765-2010
  • Fax: 352-765-2017
Mailing address:
  • Phone: 727-642-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME0075377
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME75377
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME0075377
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: