Individual
DR. JERRY N GILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 SE 17TH STREET, SUITE 300, FORT LAUDERDALE, FL 33316
(954) 468-3080
(954) 468-3082
Mailing address
1600 S. ANDREWS AVENUE, SUITE 323 WEST WING, FORT LAUDERDALE, FL 33316
(954) 355-5110
(954) 355-4919
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME71247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2505274-00
—
FL
Enumeration date
07/28/2006
Last updated
02/25/2014
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