Gillett, Edward Roger

Gillett, Edward Roger is an individual health care provider with primary practice located at 700 6Th St S , St Petersburg FL 33701-4815. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gillett, Edward Roger can be contacted via phone (727) 893-6197.

Contact Information

Primary practice address
700 6Th St S St Petersburg FL 33701-4815
Phone: (727) 893-6197
Fax: (727) 553-7340
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X ME68481 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME-68481 Florida

Profile Details

NPI number 1245219633
LBN Legal business name Gillett, Edward Roger
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Jul 27th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245219633 NPPES
Florida MEDICAID 379349400

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