Organization
WL GILMER, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM LEWIS GILMER JR. M.D. (PRESIDENT)
(386) 256-1212
Entity
Organization
Contact information
Practice address
5111 S RIDGEWOOD AVE, SUITE 104, PORT ORANGE, FL 32127-5170
(386) 256-1212
Mailing address
5111 S RIDGEWOOD AVE, SUITE 104, PORT ORANGE, FL 32127-5170
(386) 256-1212
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008424200
—
FL
Enumeration date
03/05/2013
Last updated
03/18/2016
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