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Individual

DR. MICHAEL S. GILLIGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1555 KINGSLEY AVE, SUITE 503, ORANGE PARK, FL 32073-9207
(904) 278-5088
(904) 264-4910
Mailing address
11945 SAN JOSE BLVD., BLDG 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 399-1717

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME53014
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020032009
RAILROAD MEDICARE
FL
01
0447391
CIGNA
01
05911
BCBS FL
01
204077
AVMED
01
4045261
AETNA
Enumeration date
05/04/2006
Last updated
07/22/2011
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