Provider Demographics
NPI:1972991255
Name:GILBERT, SHAKARI D (DPT)
Entity type:Individual
Prefix:DR
First Name:SHAKARI
Middle Name:D
Last Name:GILBERT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3163 LAYLA ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-7026
Mailing Address - Country:US
Mailing Address - Phone:850-559-0410
Mailing Address - Fax:
Practice Address - Street 1:2910 KERRY FOREST PKWY STE D4-291
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-6892
Practice Address - Country:US
Practice Address - Phone:850-778-0021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist