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General NPI Number Information
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NPI Number | 1801107628
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Entity Type | Individual
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Provider Name | MARCUS ANTHONY GILMORE OTR/L
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Gender | Male
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 2807 FALCONHILL DR
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City | APOPKA
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State | FL
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Zip | 32712-2444
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Country | US
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Telephone | 407-627-8010
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Fax | 800-351-9309
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Provider Business Mailing Address
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Address Line | 2807 FALCONHILL DR
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City | APOPKA
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State | FL
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Zip | 32712-2444
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Country | US
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Telephone | 407-627-8010
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Fax | 800-351-9309
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT10429
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License Number State | FL
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