Larry I Gilderman, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS0003370 Issued in FL

Practice address

1150 N University Dr
Pembroke Pines, FL 33024-5031

Phone

(954) 432-7860

Fax

(954) 432-2109

NPI assigned

Apr 11, 2006

Last updated

Jul 1, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthexcel Medical Group at Pembroke Pines

  • Surgery Physician
  • Pembroke Pines, FL
  • NPI 1740302983
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1164485843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330245031",
            "telephone_number": "954-432-7860",
            "fax_number": "954-432-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330245031",
            "telephone_number": "954-432-7860",
            "fax_number": "954-432-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDERMAN",
        "first_name": "LARRY",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0003370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052423900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Gibson
• Grayson Gigliotti
• Elizabeth Ann Gignac, D.O.
• Evelyn Alexandra Gil, D.D.S.
• Hila Gilberd, PAC
• Caitlin Giles
• Patrick Joseph Giles, RBT
• Eva Gililov, SLP
• Ileana Eugenia Gill, MD
• Tayina Sejan Gilles

• Family Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.