Basic Information
| Provider Information | |||||||||
| NPI: | 1578884607 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILLINOV | ||||||||
| FirstName: | SHELDON | ||||||||
| MiddleName: | JERRY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19586 BAY VIEW ROAD | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334345101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618522306 | ||||||||
| FaxNumber: | 5618522388 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 S CONGRESS AVE | ||||||||
| Address2: | |||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334454616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612743100 | ||||||||
| FaxNumber: | 5618375332 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2010 | ||||||||
| LastUpdateDate: | 12/21/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME105949 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.