Provider Demographics
NPI:1366220931
Name:GILL, DANIEL WINSTON
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WINSTON
Last Name:GILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 SE 6TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-4123
Mailing Address - Country:US
Mailing Address - Phone:239-822-9213
Mailing Address - Fax:
Practice Address - Street 1:13350 METRO PKWY STE 301
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-4796
Practice Address - Country:US
Practice Address - Phone:239-322-3844
Practice Address - Fax:239-673-1404
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant