Individual
MS. LUCIA ANN GILDEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(631) 422-6166
(631) 422-6266
Mailing address
100 GRANNY RD, STE 1, FARMINGVILLE, NY 11738-2879
(631) 696-4357
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
PA9105480
FL
363AS0400X
Surgical Physician Assistant
00233000
NJ
363AS0400X
Surgical Physician Assistant
Primary
012808
NY
363AS0400X
Surgical Physician Assistant
PA9105480
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IZ176Z
MEDICARE
FL
05
—
PENDING
—
FL
Enumeration date
01/11/2007
Last updated
07/09/2021
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