Basic Information
| Provider Information | |||||||||
| NPI: | 1194702530 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TEIXEIRA | ||||||||
| FirstName: | GILBERT | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4780 SW 64TH AVE STE 103 | ||||||||
| Address2: | |||||||||
| City: | DAVIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333144400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544341705 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1604 TOWN CENTER BLVD STE 4B | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333263640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543841800 | ||||||||
| FaxNumber: | 7542164197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 08/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DO00545 | RI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.