Healthcare Provider Details

I. General information

NPI: 1265964100
Provider Name (Legal Business Name): JACQUELYN TAYLOR GILBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E MARKS ST
ORLANDO FL
32803-3819
US

IV. Provider business mailing address

200 E MARKS ST
ORLANDO FL
32803-3819
US

V. Phone/Fax

Practice location:
  • Phone: 407-284-6460
  • Fax:
Mailing address:
  • Phone: 407-284-6460
  • Fax: 407-284-6461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number56098
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME179830
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: