Healthcare Provider Details

I. General information

NPI: 1326201146
Provider Name (Legal Business Name): ROOP MONICA GILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 PALM BEACH LAKES BLVD STE 118
WEST PALM BEACH FL
33409-3505
US

IV. Provider business mailing address

1920 PALM BEACH LAKES BLVD STE 118
WEST PALM BEACH FL
33409-3505
US

V. Phone/Fax

Practice location:
  • Phone: 561-388-9571
  • Fax: 561-404-8715
Mailing address:
  • Phone: 561-388-9571
  • Fax: 561-404-8715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA110466
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT186534
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME140284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: