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Individual

WALTER FRANK GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
37 N ORANGE AVE, SUITE 500, ORLANDO, FL 32801-2449
(407) 926-4124
(407) 926-4121
Mailing address
37 N ORANGE AVE, SUITE 500, ORLANDO, FL 32801-2449
(407) 926-4124
(407) 926-4121

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
300562397
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003153000
FL
Enumeration date
08/02/2011
Last updated
08/02/2011
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