MEDICARE: DR. WALTER R GIL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME0050565	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	07303	OTHER	FL	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851335376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER R GIL MD

Provider Business Mailing Address
First Line	:	5753 SWLONGSPUR LANE
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990
Country	:	US
Telephone Number	:	772-260-5368
Fax Number	:	561-748-1523

Provider Business Practice Location Address
First Line	:	5753 SW LONGSPUR LN
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-8839
Country	:	US
Telephone Number	:	772-260-5368
Fax Number	:	561-748-1523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	04/12/2017

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