Individual
JOSH GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14547 BRUCE B DOWNS BLVD, TAMPA, FL 33613-2709
(813) 979-0440
(813) 355-5054
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(813) 528-4975
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000340900
—
FL
01
—
P00982255
RR MEDICARE
FL
Enumeration date
07/17/2008
Last updated
10/29/2015
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