Individual
MARC C. GITTELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME53015
FL
208800000X
Urology Physician
Primary
ME53015
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001601400
—
FL
01
—
05776
BCBS FL
FL
01
—
1193060
WELLCARE
FL
01
—
4068398
AETNA PROVIDER #
FL
01
—
P0003164
FLORIDA HEALTHCARE PLUS
FL
01
—
P00721039
RR MEDICARE
FL
01
—
P01730303
SIMPLY HEALTHCARE
FL
01
—
QMP000004462340
MOLINA
FL
Enumeration date
04/13/2006
Last updated
04/10/2017
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