Healthcare Provider Details

I. General information

NPI: 1801232103
Provider Name (Legal Business Name): PATRICK M GILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 PASADENA AVE S
ST PETERSBURG FL
33707-2128
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 727-360-1784
  • Fax:
Mailing address:
  • Phone: 727-532-0002
  • Fax: 813-635-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME141225
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: