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General NPI Number Information
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NPI Number | 1689636268
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Entity Type | Individual
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Provider Name | OLGA GIBBONS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 3385 BURNS RD STE 203
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4328
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Country | US
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Telephone | 561-768-7886
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Fax | 561-627-3991
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Provider Business Mailing Address
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Address Line | 601 UNIVERSITY BLVD STE 104
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City | JUPITER
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State | FL
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Zip | 33458-2788
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Country | US
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Telephone | 561-768-7886
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Fax | 561-627-3991
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 161590
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME114917
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License Number State | FL
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