Healthcare Provider Details

I. General information

NPI: 1487499679
Provider Name (Legal Business Name): MR. GABRIEL D GUMBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 ALBENGA AVE # UV7-411B
CORAL GABLES FL
33146-4000
US

IV. Provider business mailing address

1527 ALBENGA AVE # UV7-411B
CORAL GABLES FL
33146-4000
US

V. Phone/Fax

Practice location:
  • Phone: 339-204-7906
  • Fax:
Mailing address:
  • Phone: 339-204-7906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: