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Individual

BOBBY LEE GIBBONS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9430 TURKEY LAKE RD, STE 114, ORLANDO, FL 32819-8015
(407) 354-1202
(407) 351-8801
Mailing address
9430 TURKEY LAKE RD, STE 114, ORLANDO, FL 32819-8015
(407) 354-1202
(407) 351-8801

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME 127210
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017398700
FL
01
ME127210
MEDICAL LICENSE
FL
Enumeration date
04/26/2011
Last updated
11/16/2016
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