Individual
DR. PAUL E. GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
(570) 271-5976
Mailing address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD437079
PA
2085R0204X
Vascular & Interventional Radiology Physician
MD437079
PA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME130359
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101186400
—
FL
01
—
4EJ6K
BCBS
FL
01
—
MD028
MEDICARE PTAN OHRI
FL
01
—
PR971
MEDICARE PTAN OHMG
FL
Enumeration date
12/16/2009
Last updated
03/27/2023
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