Provider Demographics
NPI:1104387018
Name:GIL, LUIS ANDRES (DO)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ANDRES
Last Name:GIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PARK PLACE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-6870
Mailing Address - Country:US
Mailing Address - Phone:863-419-2156
Mailing Address - Fax:
Practice Address - Street 1:105 PARK PLACE BLVD STE A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-6870
Practice Address - Country:US
Practice Address - Phone:863-419-2156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS18942207RG0100X
FL18942207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program