Provider Demographics
NPI:1588782585
Name:ABOU LAHOUD, GILBERT (MD)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:
Last Name:ABOU LAHOUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 DIAMOND CENTRE CT UNIT 1200
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-7135
Mailing Address - Country:US
Mailing Address - Phone:239-344-9786
Mailing Address - Fax:239-344-9215
Practice Address - Street 1:6150 DIAMOND CENTRE CT UNIT 1200
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912
Practice Address - Country:US
Practice Address - Phone:239-344-9786
Practice Address - Fax:239-344-9215
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125902208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016537000Medicaid
FLLSAMGOtherBCBS
FL4757577OtherAETNA
FLP972360OtherOPTIMUM
FL1247650OtherWELLCARE
FL4778797OtherCIGNA
FL389651OtherAVMED
FLP01627950OtherRR MEDICARE
FL4778797OtherCIGNA
FLLSAMGOtherBCBS
FL389651OtherAVMED