MEDICARE: GILBERT MBEO MD LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1891367819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBERT MBEO MD LLC

Provider Business Mailing Address
First Line	:	13563 NARCOOSSEE RD STE 120
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-7138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13563 NARCOOSSEE RD STE 120
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-7138
Country	:	US
Telephone Number	:	407-721-3460
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GILBERT MBEO
Credential	:	MD
Telephone Number	:	443-839-4889

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	07/18/2023

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