Healthcare Provider Details

I. General information

NPI: 1356609366
Provider Name (Legal Business Name): JENNA MARIE GIBILARO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNA MARIE CHECCHI M.D.

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S FRENCH AVE # 10031004
SANFORD FL
32771-4253
US

IV. Provider business mailing address

2200 S FRENCH AVE # 10031004
SANFORD FL
32771-4253
US

V. Phone/Fax

Practice location:
  • Phone: 407-710-0060
  • Fax: 833-973-5852
Mailing address:
  • Phone: 407-487-8884
  • Fax: 844-670-1074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME150338
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number280338
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME150138
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: