Provider Demographics
NPI:1548542384
Name:LUCIA GILLING MD PA
Entity type:Organization
Organization Name:LUCIA GILLING MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GILLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-746-5509
Mailing Address - Street 1:2252 TWELVE OAKS WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6972
Mailing Address - Country:US
Mailing Address - Phone:813-746-5509
Mailing Address - Fax:813-936-4763
Practice Address - Street 1:2252 TWELVE OAKS WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6972
Practice Address - Country:US
Practice Address - Phone:813-746-5509
Practice Address - Fax:813-936-4763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-19
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85473207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH71869Medicare UPIN