Marquisa Denise Gillard

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

217 E Mirror Lake Dr Apt a
Fruitland Park, FL 34731-3274

Phone

(352) 504-9261

NPI assigned

Apr 25, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1700440666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 E MIRROR LAKE DR APT A",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347313274",
            "telephone_number": "352-504-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E MIRROR LAKE DR APT A",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347313274",
            "telephone_number": "352-504-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLARD",
        "first_name": "MARQUISA",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Flannery
• Florida Hospital Waterman Inc
• Alyssa M Forst
• Gentle Sticks on Wheels
• Amy Giddens, OT/L
• Claudia Gonzalez
• Lauren Gordon
• Rachael Graham, RDN, LDN
• Great Expectations of Lake County Corporation
• Briana Gregory

• Developmental Disabilities Clinic/Center in Fruitland Park, FL
• Providers in Fruitland Park, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.