Provider Demographics
NPI:1194702530
Name:TEIXEIRA, GILBERT (DO)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:
Last Name:TEIXEIRA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4189
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-4189
Mailing Address - Country:US
Mailing Address - Phone:954-363-9582
Mailing Address - Fax:954-363-9663
Practice Address - Street 1:1950 W HILLSBORO BLVD STE 103
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1423
Practice Address - Country:US
Practice Address - Phone:954-408-8960
Practice Address - Fax:954-408-8961
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS19135207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H67433Medicare UPIN