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General NPI Number Information
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NPI Number | 1548548928
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Entity Type | Individual
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Provider Name | WALTER FRANK GIBSON LPN
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Gender | Male
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 37 N ORANGE AVE SUITE 500
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City | ORLANDO
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State | FL
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Zip | 32801-2449
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Country | US
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Telephone | 407-926-4124
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Fax | 407-926-4121
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Provider Business Mailing Address
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Address Line | 37 N ORANGE AVE SUITE 500
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City | ORLANDO
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State | FL
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Zip | 32801-2449
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Country | US
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Telephone | 407-926-4124
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Fax | 407-926-4121
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 300562397
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License Number State | FL
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