Healthcare Provider Details

I. General information

NPI: 1578808507
Provider Name (Legal Business Name): GABRIEL JUNIO SAPALARAN JR. BSN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2012
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 19TH ST S
BIRMINGHAM AL
35233-1927
US

IV. Provider business mailing address

700 19TH ST S
BIRMINGHAM AL
35233-1927
US

V. Phone/Fax

Practice location:
  • Phone: 205-981-3424
  • Fax:
Mailing address:
  • Phone: 205-933-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number1-078712
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: