=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609191550
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIETA GILSON M.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/05/2010
-----------------------------------------------------
Last Update Date | 06/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 350 7TH ST N
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34102-5754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-624-3997
-----------------------------------------------------
Fax | 239-624-8101
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 350 7TH ST N
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34102-5754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-643-8758
-----------------------------------------------------
Fax | 239-643-9073
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MT197436
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | ME115334
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | ME115334
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------