Healthcare Provider Details

I. General information

NPI: 1992060784
Provider Name (Legal Business Name): BROOKE GABEL PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 BAY PINES BLVD PHARMACY SERVICE (119)
BAY PINES FL
33744-8200
US

IV. Provider business mailing address

210 5TH AVE S UNIT 210
ST PETERSBURG FL
33701-4926
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-6661
  • Fax:
Mailing address:
  • Phone: 727-398-6661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-15198
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: