Provider Demographics
NPI:1992770507
Name:GILBERT, ROBERT SCOTT (PA-C)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:SCOTT
Last Name:GILBERT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-985-1925
Mailing Address - Fax:239-468-7929
Practice Address - Street 1:16420 HEALTHPARK COMMONS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-9621
Practice Address - Country:US
Practice Address - Phone:399-851-9252
Practice Address - Fax:239-321-6044
Is Sole Proprietor?:No
Enumeration Date:2006-02-18
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102417363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY08HDOtherBCBS OF FL
FL291621500Medicaid
FLP1003722OtherFREEDOM
FLP953860OtherOPTIMUM
FLP01318684OtherRR MEDICARE
FL7793508OtherAETNA
FLP95757Medicare UPIN